Disparities in cancer screening and preventive care access among LGBTQ+ populations: A cross-sectional study.

Pustake, Manas; Garikiparthy, Veeravenkata; Ganiyani, Mohammed Arfat; Ogedegbe, Oboseh John; Joshi, Swarada; Khosla, Atulya Aman; Syed, Saif; Harisingani, Avi et al. · J Family Med Prim Care · 2026

cross_sectional · Level IV

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Abstract

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. We conducted a cross-sectional analysis using the latest Behavioral Risk Factor Surveillance System. Of 278,519 respondents, participants were categorized as LGBTQ+ (<i>n</i> = 14,603) or non-LGBTQ+ (<i>n</i> = 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. LGBTQ+ respondents were younger and reported lower education and income compared to non-LGBTQ+ adults. Significant disparities were found in mammogram screening (χ<sup>2</sup> = 21.85, <i>P</i> < 0.001). Bisexual individuals (odds ratio [OR] =5.37, 95% confidence interval [CI]: 2.24-12.88, <i>P</i> < 0.001) and those identifying with "other" sexual orientations (OR = 2.96, 95% CI: 1.09-8.00, <i>P</i> = 0.033) were less likely to receive mammograms compared to heterosexual individuals. After adjustment, no significant differences were observed for cervical (<i>P</i> = 0.462) or colorectal screening (<i>P</i> = 0.709). Sexual orientation predicted only mammogram utilization. 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.