Race, sex, education level, and healthcare coverage status all contribute to cancer screening disparities among sexual and gender minority (SGM) populations, researchers reported in the March 2023 issue of the Oncology Nursing Forum.
Using data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System dataset, the research team, which included ONS member Chasity B. Walters, PhD, RN, analyzed and compared demographics and cancer screening behaviors for 12,204 SGM individuals and 391,696 non-SGM individuals. They found that certain social determinants of health either increased or decreased SGM individuals’ odds of engaging in cancer screening:
- Nonscreeners were more likely to be female or Black, report having some college or technical school or more, and have healthcare coverage.
- Screeners were more likely to be Asian, Native American, and Hawaiian or select “other” ethnicity; be younger than age 55; be unmarried; and report being in good or better health.
In their discussion, the researchers highlighted evidence-based factors that facilitate cancer screening in SGM individuals, such as willingness and being an older adult as well as having similar race and ethnicity as their healthcare providers, a history of sexual activity or abnormal Pap test results, healthcare coverage, a family history of cancer. On the provider level, cultural competency, positive communication and teamwork, knowledge of screening guidelines, welcoming environments with partner inclusion, and legal protections also increase the odds of cancer screening in SGM individuals.
“This study adds new insights to subgroups of populations who present for screening differently than other SGM populations,” the researchers concluded. “Specific knowledge about SGM populations contributes to the creation of targeted screening and prevention strategies to reduce mortality and high-risk behaviors, and to improve education models for HCPs.
“Findings from these subgroups identify screening behavior inequities and can provide a better understanding of the characteristics that place populations at risk for lack of participation in cancer screening,” they added. “The results can be used to develop HCP and patient education, expand scientific knowledge, and provide a base for future research critically needed to target interventions for enhancing cancer screening participation.”