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. 2023 Oct 17:24:101540.
doi: 10.1016/j.ssmph.2023.101540. eCollection 2023 Dec.

Inequities in colorectal and breast cancer screening: At the intersection of race/ethnicity, sexuality, and gender

Emmeline Lin  1 , Patrycja Sleboda  1 , Bobbie J Rimel  1   2 , Geetanjali D Datta  1   3
Affiliations

Inequities in colorectal and breast cancer screening: At the intersection of race/ethnicity, sexuality, and gender

Emmeline Lin et al. SSM Popul Health. .

Abstract

Objective: To investigate the joint impact of sexual orientation, gender identity, and race/ethnicity on colorectal and breast cancer screening disparities in the United States.

Methods: Utilizing sampling weighted data from the 2016 and 2018 Behavioral Risk Factor Surveillance System, we assessed differences in two metrics via chi-square statistics: 1) lifetime uptake, and 2) up-to-date colorectal and breast cancer screening by sexual orientation and gender identity, within and across racial/ethnic classifications.

Results: Within specific races/ethnicities, lifetime CRC screening was higher among gay/lesbian (within NH-White, Hispanic, and Asian/Pacific Islander) and bisexual individuals (Hispanic) compared to straight individuals, and lowest overall among transgender women and transgender nonconforming populations (p < 0.05). Asian transgender women had the lowest lifetime CRC screening (13.0%; w.n. = 1,428). Lifetime breast cancer screening was lowest among the Hispanic bisexual population (86.6%; w.n. = 26,940) and Hispanic transgender nonconforming population (71.8%; w.n. = 739); within all races, SGM individuals (except NH-White, Hispanic, and Black bisexual populations, and NH-White transgender men) had greater breast cancer screening adherence compared to straight individuals.

Conclusions: Due to small, unweighted sample sizes, results should be interpreted with caution. Heterogeneity in screening participation by SGM status within and across racial/ethnic groups were observed, revealing the need to disaggregate data to account for intersecting identities and for studies with larger sample sizes to increase estimate reliability.

Keywords: Breast cancer screening; Colorectal cancer screening; Gender minority health; Intersectionality; Screening disparities; Sexual minority health.

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Conflict of interest statement

All authors of this article declare they have no relevant conflicts of interest.

Figures

Fig. 1
Fig. 1
(A) Colorectal and (B) breast cancer screening behaviors by SGM and racial/ethnic categories separately. Weighted n's (w.n.) are reported.
Fig. 2
Fig. 2
Colorectal cancer screening behavior, (A) Lifetime and (B) Up-to-date, according to sexual orientation and race (Asian includes Pacific Islander). Complete n's, weighted n's (w.n.), and 95% confidence intervals are found in Suppl. Tables S1a and S1b.
Fig. 3
Fig. 3
Colorectal cancer screening behavior, (A) Lifetime and (B) Up-to-date, according to gender identity and race (Asian includes Pacific Islander). Complete n's, weighted n's (w.n.), and 95% confidence intervals are found in Suppl. Tables S2a and S2b.
Fig. 4
Fig. 4
Breast cancer screening behavior, (A) Lifetime and (B) Up-to-date, according to sexual orientation and race (Asian includes Pacific Islander). Complete n's, weighted n's (w.n.), and 95% confidence intervals are found in Suppl. Tables S3a and S3b.
Fig. 5
Fig. 5
Breast cancer screening behavior, (A) Lifetime and (B) Up-to-date, according to gender identity and race (Asian includes Pacific Islander). Complete n's, weighted n's (w.n.), and 95% confidence intervals are found in Suppl. Tables S4a and S4b.
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