Introduction: As of 2022, 7.1% of adults in the United States identify as LGBTQ+. It is reported that LGBTQ+ individuals have lower rates of colorectal cancer (CRC) screening but the barriers are not well understood. Furthermore, little is known about prevalence of GI symptoms among the LGBTQ+ community.
Methods: At Rochester Pride 2022, attendees completed an anonymous online/paper survey to assess frequency of common GI symptoms, CRC screening awareness and reasons for not attending CRC screening. Odds ratios were calculated using logistic regression for dichotomized outcomes and general linearized models for categorical outcomes after adjusting for age. Outcomes were considered significant when the 95% confidence intervals do not span the null and p< 0.05.
Results: 132 respondents completed the survey (Table 1). LGBTQ+ respondents (N=89) were younger than straight respondents (N=43) and had higher prevalence of cumulative GI symptoms. In the past 6 months, 43.4% of LGBTQ+ individuals reported GERD, 42.1% had experienced abdominal pain and diarrhea, 30.3% with constipation, 28.9% with bloating and 23.7% with nausea/vomiting. In general, as number of symptoms increase by one, an individual was at 33% increased odds to seek/have sought care (OR 1.332; 95% CI 1.26 – 1.730). LGBTQ+ individuals are at lower odds to seek care compared to non-LGBTQ+ individuals, though not statistically significant (OR 0.855; 95% CI 0.257 – 2.850). Within the LGBTQ+ community, those with more symptoms are also of increased odds to seek care, though not statistically significant (OR 1.127; 95% CI 0.0833 – 1.526) while within the non-LGBTQ+ community, those with more symptoms are much at higher odds to seek care (OR 4.413; 95% CI 1.305 – 14.92). LGBTQ+ individuals were familiar but less comfortable with CRC screening tests (p< 0.0049). 68.6% of LGBTQ+ individuals were either uncomfortable or neutral towards a colonoscopy compared to 39% non-LGBTQ+ individuals (p= 0.136). Fear of discrimination at healthcare setting (p< 0.0017) and at workplace or socially (p< 0.0110) were stated reasons to avoid healthcare screenings.
Discussion: This survey highlights that LGBTQ+ individuals tend to delay care despite a higher burden of common GI symptoms. Furthermore, LGBTQ+ individuals are less comfortable with CRC screening tests with fear of discrimination being the leading reason. Further studies are required to identify barriers to care in the LGBTQ+ community.
