ANNALS OF MEDICINE Cancer study considers overlooked women BY AMY HAWTHORNE

There are two kinds of women in the world — the marrieds and the not-marrieds — and the marrieds are better. Sound like some kind of Bridget Jones nightmare? Actually, this encapsulates the way that cancer researchers have viewed women for years.

A number of studies have shown that married women are more diligent in getting regular cancer screening, which is considered one of the best ways to lower cancer risk. But what about all those not-married women? Why aren’t they getting screened as often as they should? What about the distinction between women who are never married, widowed, divorced, and those living in committed relationships other than legal marriage? Melissa Clark, a researcher at Brown University, hopes to answer these questions as part of a National Cancer Institute-funded study.

The researchers are working hard to make this a truly comprehensive survey, including women between ages 40 to 75 from all communities in the state, varied socioeconomic backgrounds, different races and ethnicities, and all sexual orientations.

Lesbians are of particular interest to researchers working on this study. While previous cancer screenings have included lesbians, they did not include a comparable group of straight women and may have been skewed by the stereotypical recruitment strategy of finding subjects at sporting events and bars. This study is focused on addressing issues surrounding cancer screenings, but Clark’s methodology has expanded the scope to include women’s interactions with the health-care system at large.

The initial phase involved a focus group discussing the quality of communication between themselves and health-care workers. Forty women were then interviewed based on these observations, with their answers contributing to the ultimate design of the survey. Clark took this unusual step of essentially allowing the respondents to determine the questions because, she says, "Nobody knows enough to say, ‘These are the questions we should ask.’ "

Though the study is still recruiting subjects, it has already uncovered useful findings that have been presented to practitioners. Some of these recommendations are aimed at helping patients to feel more at ease, such as changing "spouse" to "partner" on forms and addressing the assumption that unmarried women older than 40 are not sexually active.

Other recommendations are aimed more at helping researchers make better sense of collected patient data. As Clark notes, just adding a demographic item indicating sexual orientation in patient records would yield a wealth of useful statistics. Clark has also found that many participants do not identify with the labels "straight" or "lesbian," and instead see themselves as "women who partner with women" (or men) and that many are uncomfortable with the narrow connotations of "marriage." Beyond arming medical practitioners with more knowledge about how best to treat their patients, Clark says the study has "accidentally" gathered a wealth of information that can help inform political debates surrounding marriage equality, Social Security, and the weaknesses of our current insurance system.

Clark and her team are seeking additional participants between ages 40 and 75 and who identify as a woman who partners with women. The study is confidential and participants are compensated for their time. For more info, call (866) 434-2384.