According to the US Centers for Disease Control and Prevention (CDC), over 43,000 females and 4,000 females died from breast cancer and cervical cancer, respectively, in the US in 2024. Screening plays a critical role in preventing cancer deaths as it enables physicians to identify cancer at the earlier stages, when cancers are typically easier to treat. The US Preventative Services Task Force (USPSTF) recommends biannual screening for breast cancer in those assigned female at birth (AFAB) ages 40–74 years. It also recommends cervical cancer cytology screening every three years for all AFAB [assigned female at birth] ages 21–65 years, or every five years for those ages 30–65 years in combination with high-risk human papillomavirus testing. Certain minority groups, such as sexual orientation and gender identity groups (SOGI), experience health disparities that affect preventive and diagnostic care, which may impact screening coverage. In research published in April 2026 in Cancer, Lorenza Arena and colleagues utilised data from a nationally representative telephone survey for the US, known as the Behavioral Risk Factor Surveillance System (BRFSS), to assess the associations between SOGI status and adherence to USPSTF-recommended breast and cervical cancer screening guidelines. Gender identity minority (GIM) individuals had 76% lower and 45% lower adherence to breast and cervical cancer screening, respectively, compared to cisgender respondents.
This study analysed BRFSS data from 2018–2022, and included participants who had data on sexual orientation and gender identity, and who met the eligibility criteria for breast and cervical cancer screening. Sexual orientation minorities (SOM) were defined as those who identified as either “gay/lesbian,” “bisexual,” or “something else”, and gender identity minorities (GIM) were defined as those who identified either as “transgender, female‐to‐male,” or “transgender, gender nonconforming”. Screening adherence definitions were kept analogous to USPSTF screening recommendations. Based on the analysis, SOM individuals had a 16% lower and 8% lower adherence to breast and cervical cancer screening, respectively, compared to heterosexual respondents. Additionally, GIM individuals had a 76% lower and 45% lower adherence to breast and cervical cancer screening, respectively, compared to cisgender respondents. Most notably, female-to-male respondents had a 50% lower cervical screening adherence compared to cisgender females. These trends were observed even after adjusting for age, race, income, education, marital status, employment, insurance type, and rural/urban residence.
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The study by Arena and colleagues provides evidence for the existence of screening disparities for breast and cervical cancer in SOGI minority groups, particularly for cervical cancer screening in female-to-male individuals. This highlights the importance of providing inclusive screening interventions and appropriate training for providers to minimise these screening gaps and improve healthcare equity. GlobalData epidemiologists forecast that in the US, diagnosed incident cases of breast cancer in women ages 18 years and older will increase from 289,000 cases in 2026 to 312,000 cases in 2034. Diagnosed incident cases of cervical cancer in women ages 18 years and older are expected to increase from 14,000 cases in 2026 to 14,400 cases in 2030.
