Cancer Reform Strategy - NHS Cancer Screening Programmes

92 CANCER REFORM STRATEGYReligion or belief and cancer6.41 It can sometimes be difficult to separateout factors relating to religion or belief fromother cultural and socioeconomic factors.However, attitudes to cancer may differ betweenreligions, potentially contributing to variations inuptake of screening, stage of presentation andattitudes towards treatment.6.42 Stronger commissioning will involveplanning services which are appropriate to theneeds and culture of local communities.Commissioners should therefore take intoaccount religious beliefs when designingservices.Sexual orientation and cancer6.43 Homosexual and bisexual populations canhave elevated risk factors for some cancers. Forexample, smoking rates amongst homosexualand bisexual populations are much higher (41%)than the national average (24%). Homosexualmen have a raised risk of anal cancer, related toinfection with the Human Papilloma Virus (HPV).They also have a higher rate of Kaposi Sarcomaand non-Hodgkin’s Lymphoma related toHIV/AIDS. Lesbians may be at higher risk ofbreast cancer as they are less likely to have theprotective effect of pregnancy. There is alsoevidence to suggest that they are less likely totake up screening 44 .6.44 PCTs with high homosexual, lesbian andbisexual populations may wish to considertargeted awareness-raising initiatives to addressthese issues.