Breast cancer screening in Canada 2021/2022

Strategies to improve screening for LGBTQ2S+ people

LGBTQ2S+ people may have additional barriers in accessing or participating in breast cancer screening, including stigma. Examples of LGBTQ2S+ may include gay or lesbian individuals, transgender people, non-binary people, two-spirit people, as well as many other identities.

Eight provinces have strategies which they employ to improve screening participation in these populations. Most of the strategies have been co-developed with the community. Inclusive language and specific screening guidelines and recommendations are two examples of common strategies used.

Strategies to improve screening for LGBTQ2S+ people

P/T Intended audience Intervention/strategy used Strategy co-developed with community? Description of activities to improve screening for LGBTQ2S+ people
BC · Transgender people · Website
· Printed materials
· Provider education
All: ✓ · BC Cancer Breast Screening provides information and education about screening guidance for transgender persons.
AB · People identifying as LGBTQ2S+
· PCP of LGBTQ2S+ people
· Development of culturally safe materials and resources
· Direct community engagement to co-design programs
All: ✓ · In early stages of engagement with representatives from LGBTQ2S+ communities to develop resources, appropriate inclusive language in correspondence, and supports for PCPs.
· Exploring methods to modernize how sex/gender data collection can help inform appropriate screening engagement.
SK · LGBTQ2S+ · Partnerships · Partnership with OUT Saskatoon and Health Navigators to build more inclusive screening software.
MB · LGBTQ2S+ · Inclusive guidelines · Screening recommendations for trans people are published in our guidelines
·Inclusive language used in all materials and website
· BreastCheck staff have participated in culture safety training regarding LGBTQ2S+ populations
ON · Non-binary and gender diverse people
· Ontario Health (Cancer Care Ontario) staff
1. Overarching Policy for the Screening of Trans People in the Ontario Breast Screening Program and the Ontario Cervical Screening Program
2. Educational webinars
1. ✓*
2. ✓**
· In March 2019, Ontario Health (Cancer Care Ontario) released the Overarching Policy for Screening of Trans People in the Ontario Breast Screening Program and Ontario Cervical Screening Program. The policy contains 17 recommendations on screening eligibility, interval and method for trans people at average and increased risk of breast and cervical cancer. The policy can be found at: cancercareontario.ca/en/guidelines-advice/types-of-cancer/61546. A plan to implement the policy recommendations is currently being developed.
· Ontario Health (Cancer Care Ontario) is moving towards using gender-neutral language in screening products, wherever possible. Newly developed program resources in the Ontario Breast Screening Program will include gender-neutral and inclusive language (e.g., referring to “people” as opposed to “women”); older materials are in the process of being updated.
· Ontario Health (Cancer Care Ontario) staff participated in webinars on better serving the LGBTQ2S+ community in healthcare and cancer screening (i.e., access, eligibility)
NB · General public · Inclusive language · Reviewing and adapting program correspondence, materials and media for more inclusive language and images.
NS · Transgender people · Developed draft transgender screening guidelines. · NSBSP plans to conduct focus groups to learn more about how to make breast screening more accessible to the transgender population.
PE · Extended hours and evening appointments
· All gender washrooms

ON: *Advocates, experts, and community members with expertise in better serving the LGBTQ2S+ community in healthcare (e.g., Rainbow Health Ontario) were involved in the development of the policy
ON: **Delivered by Rainbow Health Ontario