Abstract 6237: Experienced discrimination in the medical setting relating to LGBTQ+ identities and subsequent cancer screening
Authors: Stenzel Ashley E. , Rider G. Nic , Wicker Olivia S. , Teoh Deanna , Rosser B.R. Simon , Vogel Rachel I. 
Published: June 2022

Abstract
Introduction: Cancer screening disparities have been documented among LGBTQ+ individuals. Our objective was to examine how LGBTQ+-based discriminatory experiences in the clinical setting were associated with current cancer screening practices.
Methods: Participants were recruited via social media. Those who self-reported identifying within the LGBTQ+ community, being 40+ years of age, and residing in the US were eligible to participate. Participants completed a survey which collected data on health behaviors, medical history, cancer screening and preventive health resource uptake, experiences in the clinical setting, desired changes in the clinical setting, and interests in community outreach initiatives. Descriptive statistics were used to examine distributions of demographic characteristics. Chi-squared, Fisher’s exact, and Student’s t-tests were used to compare differences in cancer screening and by discriminatory clinical experiences.
Results: A total of 339 participants completed the survey. Participants were on average 54.4±9.0 years old and primarily white (92.9%). Approximately half (52.5%) of the participants were assigned female sex at birth, 46.9% male at birth, and 0.6% reported intersex characteristics. Currently, 16.8% identified as transgender and gender diverse (TGD; gender neutral, non-binary, or similar). Most participants identified as lesbian (36.9%) or gay (41.9%). Of those eligible for each cancer screening modality, most had undergone and were up to date with cancer screening via Pap testing (99.1%), mammography (93.8%), and colonoscopy (75.3%). Nearly half (44.9%) reported experiencing discrimination in the medical setting relating to LGBTQ+ identities. As compared to those without these experiences, participants who reported discrimination rated their providers as less competent in the clinical care of LGBQ and TGD patients, were less likely to have a personal provider, were less likely to have engaged in primary care in the last 12 months, were more likely to have delayed care due to costs, were less likely to disclose their sexual orientation, and were more likely to feel excluded because of gendered language (p&lt;.05). Participants who experienced discrimination were less likely to report ever having a colonoscopy (68.3% vs. 80.6%, p=0.03). Those with discriminatory experiences had a significantly increased perceived risk for breast cancer than those not reporting these experiences (31.1% vs. 17.8%, p=0.004).
Conclusions: We noted disparities among our participants with respect to cancer screening associated with past discriminatory experiences in the clinical setting. Future studies should continue to examine systemic discrimination as a key driver of LGBTQ+ disparities in cancer-screening.
Citation Format: Ashley E. Stenzel, G. Nic Rider, Olivia S. Wicker, Deanna Teoh, B.R. Simon Rosser, Rachel I. Vogel. Experienced discrimination in the medical setting relating to LGBTQ+ identities and subsequent cancer screening [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6237.