Queer in the Heartland: Cancer Risks, Screenings, and Diagnoses among Sexual and Gender Minorities in Iowa

Little is known about the cancer experiences of sexual and gender minority (SGM) persons in Midwestern areas. In response, a statewide survey of 567 SGM adults in Iowa, a largely rural Midwestern state, assessed cancer prevalence, screening tests, and related risk factors. Skin cancer accounted for nearly half of reported cancers. Individuals assigned female sex at birth reported high levels of lifetime mammograms and Papanicolaou (Pap) tests. In contrast, there were almost no colorectal cancer screenings reported among older (age 50+) respondents, regardless of gender identity or sexual orientation. Current tobacco use was modest overall, and cisgender women were more likely to report heavy drinking than cisgender men. Cisgender men age 40 and younger were less likely to have any human papillomavirus vaccination than cisgender women. The survey identified both strengths to leverage and deficits to address, which may inform future cancer prevention efforts in Iowa and other Midwestern states.