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Cancer Screening Gaps Seen in Sexual, Gender Minority Groups
A large BRFSS analysis points to persistent screening disparities among sexual orientation and gender identity minority respondents, with particularly large gaps in some gender identity minority groups.
To analyze cancer screening adherence among sexual orientation and gender identity minority groups using Behavioral Risk Factor Surveillance System data.
Approach:
Data Source: Analysis of 2018 to 2022 Behavioral Risk Factor Surveillance System data from selected US states.
Study Population: 663,924 unweighted screening-eligible adult respondents with available sexual orientation or gender identity data.
Eligibility Criteria: Defined according to US Preventive Services Task Force recommendations for colorectal, cervical, and breast cancer screening.
Screening Definitions: Self-reported adherence to screening guidelines for colorectal, cervical, and breast cancer.
Statistical Analysis: Survey-weighted Poisson regression models adjusted for demographic, socioeconomic, and health care access factors.
Key Findings:
Sexual orientation minority women reported lower adherence to cervical (adjusted prevalence ratio 0.92) and breast cancer screening (adjusted prevalence ratio 0.84) compared to heterosexual women.
Colorectal cancer screening adherence did not differ by sexual orientation among women.
Gender identity minority respondents had lower adherence to cervical (adjusted prevalence ratio 0.58) and breast cancer screening (adjusted prevalence ratio 0.24) compared to cisgender respondents.
Female-to-male transgender respondents showed lower adherence to colorectal and cervical cancer screening compared to cisgender female respondents.
An 8.3-percentage-point adherence gap in cervical cancer screening was identified between sexual orientation minority and heterosexual women.
Interpretation:
The study highlights persistent disparities in cancer screening adherence among sexual orientation and gender identity minority groups, with significant gaps particularly in cervical and breast cancer screenings.
Limitations:
Cross-sectional design and self-reported data may introduce bias.
Potential misclassification of sexual orientation and gender identity.
Non-representative sample due to optional modules and low response rates.
Lack of data on medical or surgical transition and hormone therapy use.
Conclusion:
The findings indicate ongoing disparities in cancer screening adherence among sexual orientation and gender identity minority respondents.
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