Introduction: Although a few studies have examined screening uptake among sexual minority, almost none have examined it in the specific context of rural populations. Therefore, the objective was to assess how cancer screening utilization might vary by residence (rural versus urban) and sexual orientation. Methods: Publicly available population-level data from the 2014 and 2016 Behavioral Risk Factor Surveillance System (BRFSS) were utilized. Study outcomes included recommended recent breast, cervical, and colorectal cancer (CRC) screening receipt. Independent variables of interest were residence (rural/urban) and sexual orientation (heterosexual/gay/bisexual). Weighted proportions and multivariable logistic regressions were used to assess the association between the independent variables and the outcomes. Analyses were conducted in 2018. Results: Rates for all three screenings were lowest in rural areas and among sexual minority populations (cervical cancer among lesbians, rural at 64.8%; breast cancer among lesbians, rural at 66.8%; and CRC among bisexual, rural men at 52.4%). For CRC screening, both rural gay and heterosexual rural males were less likely to receive screening (aOR=0.45; 95%=0.24-0.73 and aOR=0.79; 95%=0.72-0.87, respectively) while only rural heterosexual females were less likely (aOR=0.87; 95%=0.80-0.94). For cervical cancer screening, heterosexuals were less likely to be screened (aOR=0.83; 95%=0.72-0.94), and there were no differences for breast cancer. Conclusions: We found that rural sexual minorities may experience disparities in cancer screening utilization associated with the compounding barriers of rural residence and sexual orientation. Further work is needed to identify factors influencing these disparities and how they might be addressed.

Citation Format: Min Jee Lee, Wiley Jenkins, Eric Adjei Boakye. Cancer screening disparities among rural sexual minority individuals: Implication for prevention and policy [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C119.