Barriers to Cancer Screening Among Older LGBTQ+ Adults: A Scoping Review
Introduction
Cancer is a leading cause of death in the United States, with LGBT+ individuals reporting higher cancer rates compared to non-LGBT+ populations. Much is to be gleaned regarding these relationships among older adults. The purpose of this scoping review is to highlight the systematic barriers to cancer screening among older LGBT+ adults in the United States.
Methods
A scoping review using the PRISMA-SCR guidelines was utilized. A Population, Concept, and Context (PCC) question framework was used to organize and collect appropriate search terms in the following categories: Older Adults, LGBT Population, Cancer Screening, and Barriers or Facilitators to care. For this review, PubMed, Embase, CINAHL (Ebsco), and Web of Science databases were searched in December of 2022. After 107 duplicates were removed, 299 studies remained for an initial title and abstract review. Two independent reviewers (AY & AP) screened titles and abstracts, with a third adjudicator (TG) resolving any conflicts. Data extracted from the studies included study location, study purpose, sample population, recruitment methods, measures, results, and the use of any theoretical framework. The literature was searched from January 2000-May 2022.
Results
A total of five studies were included in our final review. Our search found five peer-reviewed articles, with the top three barriers being social support, lack of resources (e.g., insurance), and lack of knowledge. The lack of theoretical frameworks were also a hindrance to clinical care and approaches towards intervention work among cancer screening and utilization.
Conclusion
Limited research exists examining the barriers to cancer screening among older LGBT+ adults. Our results indicate that multiple systems are operating concurrently exacerbating the inequities aimed at preventing adequate cancer screening among this at-risk population. Our findings provide some of the first evidence examining these disparities among older LBGT+ adults and can inform future interventions and health care initiatives.