Gay, trans women less likely to undergo cancer screening

Article Summary

A new study published in Cancer found that gay, bisexual, and transgender women are significantly less likely to receive recommended breast and cervical cancer screenings compared to heterosexual and cisgender women, with transgender women being 76% less likely to get breast cancer screening.

  • Transgender women were 76% less likely to receive breast cancer screening and 42% less likely to get cervical cancer screening compared to cisgender women
  • Gay and bisexual women showed 16% lower breast cancer screening rates and 8% lower cervical cancer screening rates than heterosexual women
  • Researchers emphasized the need for culturally sensitive care and routine collection of sexual orientation and gender identity data in national health surveys

Disparities persist in cancer screening across various sexual orientation and gender identity populations, a study published July 6 in Cancer found. 

Women who identify as gay, bisexual, or transgender are less likely to have their breast and cervical cancer screening compared to heterosexual and cisgender women, reported a team led by Lorenza Arena, MD, and colleagues from the Ohio State University Wexner Medical Center in Columbus. 

“The study emphasizes the urgent need for targeted interventions, including improved training for providers and policy reform, to bridge these gaps and ensure equitable, inclusive care,” said senior author Timothy Pawlik, MD, PhD, from the center in a prepared statement. 

People who identify as gay, bisexual, or transgender experience disparities in healthcare access and quality of care. But the researchers noted that national data regarding adherence to recommended cancer screening among these people are limited.  

Arena and colleagues studied associations between sexual orientation and gender identity status and adherence to cancer screening recommendations by the U.S. Preventive Services Task Force (USPSTF). They used data collected between 2018 and 2022 from the Behavioral Risk Factor Surveillance System. The researchers focused on breast, cervical, and colorectal cancer screening. 

Final analysis included 663,924 survey respondents included in the system who were eligible for various cancer screening tests. Of the total respondents, 8,108 (1.2%) identified as being of sexual orientation minority while 2,315 (0.4%) identified as being of gender identity minority. And 223,065 respondents (33.5%) were assigned male at birth. 

The researchers reported the following findings: 

  • Women who identified as being of sexual orientation minority (such as gay and bisexual) were 16% and 8% less likely to receive screening tests for breast and cervical cancer, respectively, compared with heterosexual women. 

  • Men who identified as being of sexual orientation minority had a 10% higher colorectal cancer screening rate than heterosexual men.  

  • Gender identity minority (such as transgender) status was tied to a 76% and 42% lower likelihood of breast and cervical cancer screening, respectively, with no differences for colorectal cancer screening compared to cisgender patients. 

The team also observed no significant associations between sexual orientation and gender identity and cancer prevalence. 

The study authors wrote that healthcare systems should promote gender-affirming environments. This includes using nonheteronormative language, inclusive intake forms, and clinician training to improve patient–provider communication and screening participation. 

“Expanding culturally sensitive care and routinely collecting [sexual orientation and gender identity] data in national health surveys will be critical for monitoring and addressing these disparities,” the authors wrote. 

Read the full study here.

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