Zhang Hanwen, Charlton Brittany M, Schnarrs Phillip W, Trentham-Dietz Amy, Kuehne Felicitas, Siebert Uwe, Shokar Navkiran K, Pignone Michael P, Spencer Jennifer C
Health Outcomes Division, College of Pharmacy, University of Texas at Austin, Austin, Texas, USA.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Cancer. 2025 May 15;131(10):e35852. doi: 10.1002/cncr.35852.
Emerging research suggests that lesbian, gay, bisexual, and queer (LGBQ) women face barriers to breast cancer screening. The authors sought to quantify sexual identity disparities in mammography screening, health care access, and lifestyle-related risk factors using two national surveys.
Data from the 2018, 2019, and 2021 National Health Interview Survey (NHIS) and the 2018, 2020, and 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed. The authors performed meta-analyses to determine the relative risks (RRs) of self-reported, up-to-date mammography for women identifying as LGBQ versus those identifying as straight. Differences in health care access and lifestyle-related breast cancer risk factors were also assessed by sexual identity.
LGBQ women reported lower up-to-date mammography (pooled RR [pRR], 0.95; 95% confidence interval [CI], 0.92-0.98) versus straight women, driven by differences among bisexual/queer women (pRR, 0.91; 95% CI, 0.87-0.95) and those entering screen-eligibility at ages 40-49 years (pRR, 0.86; 95% CI, 0.80-0.91) and 50-59 years (pRR, 0.93; 95% CI, 0.88-0.98). LGBQ women were more likely than straight women to be uninsured (BRFSS survey [8.6%; 95% CI, 6.5%-11.2%] vs. NHIS [5.1%; 95% CI, 4.8%-5.4%]) and to experience financial barriers to care (BRFSS survey [13.8%; 95% CI, 11.6%-16.3%] vs. NHIS [8.9%; 8.5%-9.2%]). Lifestyle-related breast cancer risk factors were more common among LGBQ women versus straight women, including current smoking (BRFSS survey [19.0%; 17.1%-21.2%] vs. NHIS [13.9%; 13.6%-14.3%]).
LGBQ women were more likely than straight women to be exposed to breast cancer risk factors, which were compounded by lower screening and facing health care access barriers. It is crucial to identify interventions for screening and risk reduction that are accessible and effective for LGBQ women, particularly bisexual/queer women and those aging into screen-eligibility.
新兴研究表明，女同性恋、男同性恋、双性恋和酷儿（LGBQ）女性在乳腺癌筛查方面面临障碍。作者试图通过两项全国性调查来量化乳房X线摄影筛查、医疗保健可及性以及与生活方式相关的风险因素方面的性取向差异。
分析了2018年、2019年和2021年全国健康访谈调查（NHIS）以及2018年、2020年和2022年行为危险因素监测系统（BRFSS）调查的数据。作者进行了荟萃分析，以确定自我报告的、最新乳房X线摄影检查对于认同LGBQ的女性与认同异性恋的女性的相对风险（RRs）。还按性取向评估了医疗保健可及性和与生活方式相关的乳腺癌风险因素的差异。
与异性恋女性相比，LGBQ女性报告的最新乳房X线摄影检查率较低（合并RR [pRR]，0.95；95%置信区间[CI]，0.92 - 0.98），这是由双性恋/酷儿女性（pRR，0.91；95% CI，0.87 - 0.95）以及40 - 49岁（pRR，0.86；95% CI，0.80 - 0.91）和50 - 59岁（pRR，0.93；95% CI，0.88 - 0.98）进入筛查适宜年龄的女性之间的差异所驱动。与异性恋女性相比，LGBQ女性更有可能未参保（BRFSS调查[8.6%；95% CI，6.5% - 11.2%] 对NHIS [5.1%；95% CI，4.8% - 5.4%]），并且在获得医疗保健方面面临经济障碍（BRFSS调查[13.8%；95% CI，11.6% - 16.3%] 对NHIS [8.9%；8.5% - 9.2%]）。与生活方式相关的乳腺癌风险因素在LGBQ女性中比在异性恋女性中更常见，包括当前吸烟（BRFSS调查[19.0%；17.1% - 21.2%] 对NHIS [13.9%；13.6% - 14.3%]）。
与异性恋女性相比，LGBQ女性更有可能暴露于乳腺癌风险因素，而较低的筛查率以及面临医疗保健可及性障碍使情况更加复杂。确定对LGBQ女性，特别是双性恋/酷儿女性以及进入筛查适宜年龄的女性可及且有效的筛查和降低风险干预措施至关重要。
Zotero 插件