Participation, Barriers, and Facilitators of Cancer Screening Among LGBTQ+ Populations: A Review of the Literature
Notice bibliographique
Résumé
ABSTRACT Compared with cisgender and heterosexual individuals, members of the LGBTQ+ community experience worse health outcomes. This is due to a combination of structural inequities and life experiences, including higher rates of mental illness and suicidality, sexually transmitted infections, and certain cancers. Men who have sex with men are at higher risk of anal cancer, and lesbian and bisexual women are often diagnosed with breast cancer at younger ages than heterosexual women partly due to lower parity and higher bodyweight. Despite these increased risks, some evidence shows the LGBTQ+ population is less likely to participate in early detection and cancer screening programs; however, the etiology of this is unknown. This review aims to summarize the current literature on cancer screening uptake in the LGBTQ+ population, including barriers and facilitators associated with screening participation. Studies published between January 2001 and April 2022 involving individuals identified as a gender or sexual minority that assessed participation in and/or facilitators and barriers to a cancer screening procedure were included. Barriers and facilitators identified in quantitative studies were reported on the individual-, provider-, and administrative/system-level scale. A total of 50 publications were included, 38 of which were quantitative, 10 were qualitative, and 2 used mixed methods. Among 16 relevant studies, considerable variation was identified when analyzing whether sexual minority women had lower participation in cervical cancer screening programs. Among 15 studies assessing the participation of sexual minority women compared with heterosexual women in breast cancer screening, 5 studies found no difference, whereas the remainder suggested lower rates of screening among sexual minority women. Fewer studies assessed screening among sexual minority men; however, sexual minority men were more likely to report anal cancer screening than heterosexual men. Cervical cancer screening participation among transgender men and gender diverse participants was lower than cisgender participants in almost all studies. Of 9 studies reporting breast cancer screening among gender diverse or transgender individuals, 5 found lower participation among transgender or gender diverse individuals compared with cisgender women. One study identified greater odds of up-to-date mammography among transgender men compared with cisgender women. The most common individual-level barriers to screening are related to knowledge of the screening tests themselves, including screening guidelines, procedures, pain, embarrassment, and a fear of results. One of the strongest correlates in studies was perceived discrimination from health care providers, which often resulted in lack of disclosure of sexual orientation or gender identity. Provider-level factors mostly included provider communication and relationship with the patient, and patients preferred providers experienced with LGBTQ+ clients and that used sexuality-inclusive language. Having open communication about sexual orientation and gender identity was a positive facilitator for all patients. System-level barriers included inclusive documentation and physical environments in health care. This review highlights key disparities including the lower screening rates among transgender patients in all categories and lower screening rates for cervical cancer and mammography among sexual minority women. It also highlights a significant need for representative data on all LGBTQ+ populations.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,034 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,000 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».