Austin Waters

1 Introduction Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals, who make up 9.3% of the United States (US) population, are more likely to take on primary caregiver roles than non-LGBTQ+ individuals [1-3]. Caregivers provide unpaid care such as assisting with activities of daily living, managing side effects of treatment, healthcare decision-making, providing emotional support and many other duties.

Waters AR, Warner EL, Wilson J, Rosenstein DL, Hall WJ, Kent EE. Differences in Discrimination, Violence, Mental Health, and Substance Use Outcomes by Cancer History Among LGBTQ+ Individuals in North Carolina. North Carolina Medical Journal. Published online March 25, 2025. doi: 10.18043/​001c.127405 Introduction Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals make up at least 7.1% of the US population.

1 INTRODUCTION In 2019, the projected patient economic burden of cancer in the United States, including out-of-pocket costs and time costs, was estimated to be $21.1 billion.1 A systematic review assessing the prevalence of cancer-related financial burden found that nearly half of cancer survivors experienced some form of financial burden.2 Further recent literature suggests that the prevalence of financial burden among cancer survivors is likely even higher following the economic impact of...