Cancer screenings among sexual and gender minorities by midwives' point of view

Minerva Obstet Gynecol. 2022 Dec;74(6):522-529. doi: 10.23736/S2724-606X.21.04802-8. Epub 2021 May 4.

Abstract

Introduction: Although women belonging to sexual and gender minorities are more at risk of gynecological and breast cancer, pieces of evidence have been provided that this population finds hardships getting involved in cancer screening programs. This happens because they tend to avoid clinical settings because of fear of discrimination, heteronormative assumptions, heterosexism, classism, and homophobic slurs by healthcare professionals. On the other hand, medical programs that allow healthcare providers to have experience with LGBTQ people are scarce and there are no specific tools to assess sexual cancer risks in this population.

Evidence acquisition: Studies included were obtained searching MEDLINE with keywords "lesbians," "queer women," "trans women," "LGBTQ women," "cervical cancer screening," "pap test," "oncology screening," "mammogram" and "prevention." Furthermore, 1577 papers were found. After filtering for species, sex, language, and time range, 820 papers were left. The number of works included was 24 after title screening and 20 after abstract screening and full-text screening.

Evidence synthesis: More research will be needed to develop tools with an inclusive, non-judgmental, and open language capable of engaging the LGBTQ community. Cancer screening programs involve a large variety of healthcare providers including midwives.

Conclusions: Midwives are multifaceted healthcare professionals whose large competence spectrum includes a variety of knowledge and skills going from antenatal care to education and research and they may efficiently provide cancer screenings. Midwives have been asking for more specialistic roles and calling for specific instruction to face the complex and ever-changing reality.

MeSH terms

  • Early Detection of Cancer
  • Female
  • Humans
  • Midwifery*
  • Pregnancy
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Uterine Cervical Neoplasms* / diagnosis