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Colorectal Cancer Screening Compliance Among Sexual Minority Subpopulations After the 2021 Updated U.S. Preventive
Laggy George1, Rachel Liu-Galvin2, Young-Rock Hong3,4
1Department of Public Health, University of North Florida, Jacksonville, Florida.
Introduction:
The U.S. Preventive Services Task Force updated its colorectal cancer screening guidelines in 2021; however, little is known about adherence to these updated guidelines among sexual minority populations.
Methods:
Using data from the 2022 Behavioral Risk Factor Surveillance System, this study analyzed the adjusted prevalence ratios of up-to-date colorectal cancer screening across sexual orientation groups (straight, gay/lesbian, bisexual, and another sexual orientation [defined as something else]) using modified Poisson regression with robust variance estimation adjusted for sociodemographic factors. Analyses were further stratified by age group (45-49, 50-64, and 65-75 years) and sex.
Results:
The study included 173,381 respondents (weighted N=93,061,050) aged 45-75 years. Overall, the prevalence of up-to-date colorectal cancer screening ranged from 58.4% (another sexual orientation), 62.7% (bisexual), and 68.8% (straight) to 69.0% among gay/lesbian individuals (p<0.001). Individuals with another sexual orientation had a significantly lower prevalence than both straight individuals (adjusted prevalence ratio=0.90; 95% CI=0.84, 0.97) and gay/lesbian individuals (adjusted prevalence ratio=0.90; 95% CI=0.82, 0.98). When stratified by age and sex, individuals with another sexual orientation consistently had lower likelihoods of being up to date with colorectal cancer screening in the 65-75 age group and among female participants than among their straight counterparts.
Conclusions:
Colorectal cancer screening among individuals with another sexual orientation consistently had a lower prevalence of up-to-date colorectal cancer screening than among straight and gay/lesbian individuals and did not differ significantly from that for gay/lesbian or bisexual individuals. This disparity was primarily driven by females and those aged 65-75 years, highlighting the need for age- and sex-tailored interventions.
