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

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