AACR: Routine Cervical Cancer Screening Low Among Women Who Identify as Lesbian
“Despite our knowledge of the value of Pap testing for early detection of treatable cervical abnormalities, lesbians are one subset of women who are not getting screened at recommended rates,” said J. Kathleen Tracy, PhD, of the University of Maryland School of Medicine, Baltimore, MD.
A standardized internet survey assessing recent cervical cancer screening behaviors and perceived barriers to screening was sent to 3,000 self-identified lesbians. Of the 1,006 respondents from across the United States, 62% of the weighted sample underwent routine screening. The most commonly cited reasons for lack of screening were no physician referral (17.5%) and absence of a physician (17.3%).
Adjusting for age, education, and status of relationship, employment, and insurance, women who had disclosed their sexual orientation to their primary care physician were 2.8 times more likely to undergo routine screening vs those who did not disclose (95% CI 1.82–4.45). Similarly, those who disclosed to their gynecologists were 2.3 times more likely to undergo routine screening (95% CI 1.33–3.96).
“When this finding is coupled with that of the potency of provider recommendation, it underscores how critical effective communication between patient and provider is for optimal health and disease prevention,” Dr. Tracy said. In addition, women who knew that not having a Pap test is a risk factor for cervical cancer were nearly two times more likely to undergo routine screening. No association with screening was found for women who had additional information about general cervical cancer risk factors.
“This study highlights an often overlooked cancer disparity,” she said. “We know that human papillomavirus can be transmitted during same-sex sexual activity, so lesbians are at risk for developing cervical cancer. If this group of women doesn't participate in screening, they are at elevated risk for developing cervical cancer via missed opportunities to identify and treat precursor abnormalities.”
The study was funded by the National Cancer Institute.