Lung Cancer Screening Eligibility and Utilization among Transgender Patients: An Analysis of the 201
Monday, December 21, 2020
Posted by: Natalia Gromov
Justin
T Stowell, Yasha Parikh, Kimberly Tilson, Anand K Narayan
Lung Cancer Screening
Eligibility and Utilization among Transgender Patients: An Analysis of the
2017–2018 United States Behavioral Risk Factor Surveillance System Survey.
Nicotine & Tobacco Research, Volume 22, Issue 12, December 2020, Pages
2164–2169, https://doi.org/10.1093/ntr/ntaa127
Introduction. Transgender
and gender diverse (TGD) persons disproportionately face many health
disparities including a higher risk of lung cancer. Lung cancer screening (LCS)
using low-dose chest computed tomography has reduced lung cancer mortality in
eligible high-risk smokers across several large trials, yet utilization of LCS
remains low. TGD persons may be less likely to receive recommended cancer
screening compared with cisgender populations. We sought to compare eligibility
for and utilization of LCS between TGD and cisgender persons in the United
States. We also examined if the utilization of LCS varied by smoking status
within each gender identity group.
Methods. We
analyzed data from the 2017 and 2018 Behavioral Risk Factor Surveillance System
(BRFSS) cross-sectional survey to determine eligibility and utilization of LCS
among TGD participants compared with cisgender persons. Logistical regression
analysis of potentially confounding variables included age category,
race/ethnicity, income, employment status, health insurance, and having a
personal doctor.
Results. Of
37 023 weighted respondents, 0.5% were TGD. Although eligibility for LCS was
statistically similar (8.8% TGD vs. 12.2% cisgender) (adjusted odds ratio =
0.81, 95% confidence interval = 0.27–2.39, p = .703), only 2.3% of TGD
participants reported obtaining a LCS chest computed tomography versus 17.2% of
cisgender participants (adjusted odds ratio = 0.04, 95% confidence interval =
0.01–0.59, p = .019). Smoking status showed no association with LCS utilization
among gender identity groups.
Conclusions. TGD
persons may be less likely to receive LCS despite having similar smoking status
and eligibility of cisgender persons, suggesting a disparity in utilization of
this preventative health service.
Implications. Targeted
efforts to increase LCS utilization and promote smoking cessation for at-risk
TGD patients may be warranted.
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