71 Quick summary: Comprehensive survey data reveals that sexual and gender minority populations face stark disparities in preventive oncology, with transgender individuals up to 76% less likely to undergo essential breast and cervical cancer screenings compared with cisgender women. These significant gaps in preventative services are driven by systemic barriers within healthcare settings, including a lack of culturally competent providers, historical mistrust, and widespread discrimination. For public policy and healthcare practice, addressing these disparities through targeted provider training and comprehensive data integration is crucial to ensure equitable care, promote early cancer detection, and protect the physical well-being of marginalised groups. New research has uncovered persistent disparities in preventive cancer care across different sexual orientation and gender identity populations, with particular concern for cervical and breast cancer screening. The study was published online in the journal CANCER, a peer-reviewed publication of the American Cancer Society. Investigators analysed data from the 2018–2022 Behavioral Risk Factor Surveillance System, a nationally representative annual telephone survey of US adults. Among 663924 respondents who were eligible for different cancer screening tests, sexual orientation minority women, such as those who are gay or bisexual, were 8% less likely to receive screening tests for cervical cancer and 16% less likely for breast cancer, compared with heterosexual women. In men, sexual orientation minorities had a 10% higher colorectal cancer screening rate than heterosexual men. Compared with cisgender status, gender identity minority status, such as transgender individuals, was associated with a 42% and 76% lower likelihood of cervical cancer and breast cancer screening, respectively. There were no differences for colorectal cancer screening, and sexual orientation and gender identity were not associated with meaningful differences in cancer prevalence. Cervical cancer screening typically involves Pap tests or HPV testing, recommended for many women and people with a cervix starting around age 21–25. Breast cancer screening often refers to mammograms, commonly advised from age 40 or 50 depending on guidelines and risk factors. Colorectal screening includes colonoscopies or stool tests from around age 45. Experts note that barriers for sexual and gender minority groups can include discrimination in healthcare settings, lack of culturally competent providers, and historical mistrust. Previous studies have also pointed to challenges for LGBTQ+ communities, including higher rates of certain risk factors like smoking in some subgroups, and lower engagement with preventive services due to systemic issues. The inclusion of sexual orientation and gender identity questions in surveys like the Behavioral Risk Factor Surveillance System has helped illuminate these patterns. “The current data highlight how sexual and gender minority populations, particularly transgender individuals, face significant disparities in accessing breast and cervical cancer screenings,” said senior author Timothy M. Pawlik, MD, of The Ohio State University Wexner Medical Center. “The study emphasises the urgent need for targeted interventions, including improved training for providers and policy reform, to bridge these gaps and ensure equitable, inclusive care.” Health professionals say the findings underscore the importance of inclusive practices, including routine collection of sexual orientation and gender identity data in medical records, sensitivity training for staff, and tailored outreach programmes. Policy changes could involve expanding insurance coverage for screenings and addressing affordability barriers. For individuals in sexual and gender minority groups, advocates recommend seeking providers who are affirming and knowledgeable about specific health needs, along with regular discussions with healthcare professionals about personal risk and screening schedules. While cancer prevalence showed no major differences by sexual orientation and gender identity in this dataset, the lower screening rates among certain groups could lead to later diagnoses and worse outcomes if unaddressed. Further research may explore the underlying causes of these disparities and test interventions designed to improve uptake, as healthcare systems work to integrate equity into cancer prevention strategies.