Barriers and Facilitators to Cancer Screening Among LGBTQ Individuals With Cancer.
Kelly S Haviland, Shannon Swette, Teresa Kelechi and 1 others
PMID 31845916WHAT IT FOUND
LGBTQ patients often avoided cancer screening because they feared discrimination and providers assumed heterosexuality.
Asking sexual orientation and gender identity respectfully, recommending screening, and making exams comfortable were described alongside more screening.
Key findings
01Providers assuming patients' sexual orientation and gender identity matched their sex assigned at birth, or not asking about them, was tied to missed screening.
02Lesbian, bisexual, and transgender men who received a provider recommendation were four times more likely to be screened routinely.
03Transgender men reported severe distress with cervical screening because the exam involves female anatomy not aligned with their gender.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Findings do not generalise to all LGBTQ groups or other diverse populations. Search terms may have missed applicable studies. Participants were likely motivated to join research, so people with more distress about disclosure may be missing. Themes were extrapolated by one reviewer and may be subject to bias. The reviewed studies included very few transgender or queer participants, limiting population estimates. HIV-focused studies were excluded, so screening issues tied to HIV were not captured. Only U.S. English studies from 2008 to 2018 were included.
The easy way to misread this
Do not conclude that asking about sexual orientation or recommending screening will cause more screening. This review describes barriers and facilitators from observational studies; it does not test an intervention.