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Disparities in cancer screening and preventive care access among LGBTQ+ populations: A cross-sectional study
Manas Pustake1, Veeravenkata Garikiparthy1, Mohammed Arfat Ganiyani2
1Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Background:
Cancer screening is vital for early detection and improved survival, yet disparities persist among marginalized groups. Sexual and gender minority (LGBTQ+) populations face barriers to preventive care, including discrimination, limited access to affirming providers, and socioeconomic inequities. This study evaluates differences in mammogram, cervical, and colorectal cancer screening between LGBTQ+ and non-LGBTQ+ adults using nationally representative data.
Materials And Methods:
We conducted a cross-sectional analysis using the latest Behavioral Risk Factor Surveillance System. Of 278,519 respondents, participants were categorized as LGBTQ+ (n = 14,603) or non-LGBTQ+ (n = 258,942) after excluding missing data. Descriptive statistics and Chi-square tests assessed demographic and screening differences. Logistic regression models estimated associations between sexual orientation and screening uptake, adjusting for age, race/ethnicity, education, and income. Statistical significance was set at α =0.05.
Results:
LGBTQ+ respondents were younger and reported lower education and income compared to non-LGBTQ+ adults. Significant disparities were found in mammogram screening (χ2 = 21.85, P < 0.001). Bisexual individuals (odds ratio [OR] =5.37, 95% confidence interval [CI]: 2.24-12.88, P < 0.001) and those identifying with "other" sexual orientations (OR = 2.96, 95% CI: 1.09-8.00, P = 0.033) were less likely to receive mammograms compared to heterosexual individuals. After adjustment, no significant differences were observed for cervical (P = 0.462) or colorectal screening (P = 0.709). Sexual orientation predicted only mammogram utilization.
Conclusions:
Disparities in cancer screening persist, particularly in mammogram use among bisexual and other LGBTQ+ individuals. These findings highlight the need for targeted public health interventions, culturally competent care, and inclusive data collection to reduce structural barriers and improve screening equity for LGBTQ+ populations.
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