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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Sexual orientation and gender identity minority individuals had lower adherence to guideline-recommended cancer screening. Targeted interventions are needed at the health system, policy and payer levels. Persistent disparities in preventive cancer care exist among sexual orientation and gender identity minority individuals in the United States, according to results of a cross-sectional analysis. The findings \u2014 which revealed particularly concerning gaps related to breast cancer and cervical cancer screening \u2014 highlight the need for targeted interventions at the health system, policy and payer levels to eliminate structural and systemic barriers and ensure equitable access, researchers concluded.
Data derived from Arena L, et al. Cancer. 2026;doi:10.1002\/cncr.70462.
Timothy M. Pawlik \u201cPrior literature had suggested that health care access and utilization among this specific population is worse, so I wasn\u2019t all that surprised by the results. That said, it is sobering when \u2014 even after adjustments for demographic and socioeconomic factors \u2014 we see sexual orientation and gender identity still had an independent effect on screening compliance,\u201d senior author Timothy M. Pawlik, MD, MPH, PhD, chair of the department of surgery and Urban Meyer III and Shelley Meyer Chair for Cancer Research at The Ohio State University Wexner Medical Center, told Healio. Distinct barriers Sexual orientation and gender identity (SOGI) minority individuals \u2014 which include but are not limited to people who identify as lesbian, gay, bisexual or transgender \u2014 account for approximately 5.5% of U.S. adults. Up to 16% of SOGI individuals have reported discrimination in health care settings, and a similar percentage report avoiding health care because they anticipate mistreatment, according to study background. Prior research suggests SOGI individuals are at elevated risk for cancer due to multiple distinct but interconnected pathways. These include structural barriers in the health care system; psychosocial stressors such as homophobia or transphobia; increased risk for exposure to HIV or HPV infections; and behaviors such as smoking or alcohol use that may be triggered by psychological stress. As Healio previously reported, disparities in access to and quality of care for LGBTQ+ individuals with cancer are more pervasive than previously understood. In addition, cancer survivors who identify as LGBTQ+ are at greater risk for several chronic health issues, such as myocardial infarction, diabetes or asthma. However, most cancer registries do not collect SOGI data, so evidence about national trends in cancer prevalence and screening adherence in this population is limited. Pawlik and colleagues sought to assess associations between SOGI status and adherence to U.S. Preventive Services Task Force recommendations for three cancer screenings. \u201cWe know these individuals encounter distinct barriers than other traditionally marginalized groups,\u201d Pawlik said. \u201cBarriers that prevent more universal adoption of screening recommendations could result in differential outcomes in cancer management due to late detection, so we specifically wanted to look at utilization and compliance with screening recommendations in this population.\u201d The investigators used 2018-2022 data from the Behavioral Risk Factor Surveillance System \u2014 an annual telephone survey of U.S. adults \u2014 to identify those who met USPSTF guideline criteria to be screened for breast cancer, cervical cancer or colorectal cancer. Researchers categorized respondents as heterosexual or sexual orientation minority individuals, and as cisgender or gender identity minority individuals. The analysis included data from 663,924 screening-eligible respondents, 8,108 (1.2%) of whom identified as sexual orientation minorities and 2,315 (0.4%) of whom identified as gender identity minorities. Two-thirds (67.9%) identified as white and one-third (33.5%) had been assigned male at birth. A higher percentage of sexual orientation minority individuals than heterosexual respondents reported being uninsured (11.8% vs. 7.2%) and having no personal physician (18% vs. 12.9%). A higher percentage of gender identity minority individuals than cisgender respondents reported having no personal physician (17.9% vs. 2.2%), but insurance coverage did not differ significantly. \u2018Potentially more advanced cancers\u2019 Researchers analyzed data using multivariable models that adjusted for race, ethnicity, education, income, marital status, insurance type, employment status and area of residence (urban vs. rural). Results showed sexual orientation minority women had 16% lower adherence to breast cancer screening (adjusted prevalence ratio [aPR] = 0.84; 95% CI, 0.77-0.92) and 8% lower adherence to cervical cancer screening (aPR = 0.92; 95% CI, 0.87-0.97) than heterosexual women. Gender identity minority individuals had a 76% lower likelihood of adhering to screening for breast cancer (aPR = 0.24; 95% CI, 0.08-0.74) and a 42% lower likelihood of adhering to screening for cervical cancer (adjusted PR = 0.58; 95% CI, 0.37-0.9) than cisgender individuals. Colorectal cancer screening adherence appeared slightly higher among sexual orientation minority men (aPR = 1.1; 95% CI, 1-1.21) but did not differ based on gender identity. Despite differences in screening adherence, SOGI status did not appear associated with meaningful differences in cancer prevalence. However, due to the study design and inherent limitations of retrospectively analyzing administrative data, researchers are more confident in the findings related to screening, Pawlik said. \u201cThe findings have important clinical and public health implications,\u201d he said. \u201cEven though we are glad we didn\u2019t see differences in cancer prevalence, we have to acknowledge that lower screening rates will place individuals at higher risk for being diagnosed with potentially more advanced cancers.\u201d Eliminating barriers The findings underscore the importance of multipronged efforts to eliminate barriers and increase screening uptake, according to researchers. Pawlik and colleagues outlined several strategies: Health care systems should promote gender-affirming environments through the use of nonheteronormative language and inclusive intake forms, and by offering alternative screening approaches such as self-collected HPV testing. Additional training should be offered to enhance clinician-patient communication about the importance of screening for SOGI individuals. Insurers\u2019 coverage policies should ensure screening recommendations<\/p>\n","protected":false},"author":1,"featured_media":3052,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3051","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3051","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3051"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3051\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/3052"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3051"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3051"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3051"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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