Abstract P024: Participation, barriers, and facilitators of cancer screening among sexual and gender minority groups: a scoping review
Authors: Heer Emily , Peters Cheryl , Knight Rod , Yang Lin , Sutherland Liam , Heitman Steven J. 
Published: January 2023

Background: Sexual and gender minority populations are at higher risk for certain cancers but less likely to engage with preventive healthcare such as cancer screening services. Despite this, the barriers, and facilitators to cancer screening among this population are not well understood. Methods: We conducted a systematic search of MEDLINE articles published between January 2001 and April 2021 related to sexual and gender minority group participation in cancer screening, as well as barriers and facilitators to participation. The search yielded 3,058 results and, following abstract and full-text screening, 51 quantitative and qualitative studies were included in the final synthesis. Results: When compared to their heterosexual counterparts, sexual minority women were less likely to participate in cervical cancer screening and mammography, while sexual minority men were more likely to participate in anal and colorectal cancer screening. Transgender individuals had lower rates of screening than cisgender individuals for all cancer types. Barriers to participation were found at the individual-, provider-, and administrator-levels. Individual-level factors included lack of knowledge about screening, fear of pain and embarrassment, and a fear of results (which could be both a negative and positive factor for screening participation). Not disclosing sexual orientation or gender identity to a healthcare provider was a barrier to screening participation, where perceived or previous experiences with discrimination from healthcare providers was an important factor in deciding whether to disclose. Lack of provider knowledge and use of (mis)gendered or heteronormative language by providers were significant barriers to screening and prevented patients from disclosing their identity. The strongest administrative barrier was a lack of LGBTQ-inclusive documentation and physical environments in healthcare. Conclusions: Our findings provide insights into how participation rates for sexual and gender minorities in cancer screening can be improved. Patient-centered approaches should draw on core guiding principles to inform the provision of sexual and gender minority care, including anticipating sexual and gender minority patients (including establishing a safe space for sexual and gender minority patients), improving knowledge about care for these patients, and confronting individually held biases that may affect care, to improve care experiences and participation rates in preventive services.

Citation Format: Emily Heer, Cheryl Peters, Rod Knight, Lin Yang, Liam Sutherland, Steven J. Heitman. Participation, barriers, and facilitators of cancer screening among sexual and gender minority groups: a scoping review. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P024.