Patients who identify as a sexual minority are less likely than heterosexual patients to undergo cervical cancer screening, according to a study published in Cancer.
The study also showed that Hispanic sexual minorities were the group least likely to undergo screening, and non-Hispanic Black heterosexuals were the group most likely to undergo screening.
For this study, researchers analyzed data from the 2015 and 2018 editions of the US National Health Interview Survey.
The evaluable cohort included 877 sexual minority patients and 17,760 heterosexual patients, ages 21 to 65 years, who reported their sexual orientation and Pap testing history. Sexual minority patients were defined as those who self-reported as lesbian or gay, bisexual, or something else/unsure of their orientation.
The odds of ever undergoing a Pap test was significantly lower in sexual minority patients than in heterosexual patients (odds ratio [OR], 0.54; 95% CI, 0.42-0.70).
The findings were similar when the researchers looked at the subgroups within the sexual minority group. However, only the group identifying as “something else/unsure” had significantly lower odds of undergoing Pap testing (OR, 0.29; 95% CI, 0.19-0.45), when compared with heterosexuals.
The researchers also evaluated patients according to race and ethnicity in conjunction with sexual orientation.
The team found that the odds of ever undergoing a Pap test were significantly lower for Hispanic sexual minorities (OR, 0.26; 95% CI, 0.15-0.43) and non-Hispanic White sexual minorities (OR, 0.62; 95% CI, 0.42-0.91), when compared with non-Hispanic White heterosexuals.
There was no significant difference in the odds of ever having undergone a Pap test for non-Hispanic Black sexual minorities (OR, 0.64; 95% CI, 0.25-1.60) or Hispanic heterosexuals (OR, 0.84; 95% CI, 0.68-1.04), when compared with non-Hispanic White heterosexuals. However, non-Hispanic Black heterosexuals had significantly greater odds of ever having undergone a Pap test (OR, 1.32; 95% CI, 1.01-1.73).
The researchers concluded that most patients with a cervix who identify as a sexual minority, regardless of race or ethnicity, have reduced odds of ever undergoing any Pap testing.
“Future work should examine disparities in Pap testing through an intersectional lens to not only identify groups at greater risk for not receiving such care but also examine systemic discrimination and identify where the system may be failing, potential interventions in clinical care at the institutional level, and opportunities for community outreach,” the researchers concluded.
Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Stenzel AE, Bustamante G, Sarkin CA, et al. The intersection of sexual orientation with race and ethnicity in cervical cancer screening. Cancer. Published online May 16, 2022. doi:10.1002/cncr.34213