Cervical cancer screening in Canada: 2021/2022

Strategies to improve screening for LGBTQ2S+ people

LGBTQ2S+ people may have additional barriers in accessing or participating in cervical 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.

Seven 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 audiences Strategies used  Strategy co-developed with community? Description of activities to improve screening for LGBTQ2S+ people
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 · LBGTQ2S+ community · Revised guidelines will include information specific to LGBTQ2S+ health needs
MB · LGBTQ2S+ ✓* · The cervical cancer screening guidelines include specific guidelines for transgender individuals, and utilizes inclusive language
· Program distributes educational resources that target LGBTQ2S+ individuals
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. ✓^ Advocates, experts, and community members with expertise in better serving the LGBTQ2S+ community in healthcare were involved in the development of the policy
2. ✓~
· This policy includes cervical screening recommendations for trans men and gender diverse people. A plan to implement the policy recommendations is currently being developed.
· Newly developed program resources in the Ontario Cervical Screening Program will include gender-neutral and inclusive language (e.g., referring to “people with a cervix” 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 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
· LGBTQ2S+ People
· Health PE Committee · Meetings to discuss healthcare needs, improvement
NL   · Provision of program promotional and education materials to encourage program participation
· Engagement with primary care professionals to encourage clients’ referrals
· Collaboration and engagement with health clinics that serve members of the LGBTQ2S+ community

*Quebec does not have an organized screening program available so there are no concerted strategies in place.
MB: ^Work in consultation with LGBTQ2S+ community groups to ensure that all resources utilize inclusive language.
ON: ~Advocates, experts, and community members with expertise in better serving the LGBTQ2S+ community in healthcare were involved in the development of the policy
ON: **Delivered by Rainbow Health Ontario