Background: Cervical cancer screening is recommended for those with a cervix who are 21 to 65 years old, with specific timelines being dependent on individual risk. This study compared rates of ever undergoing Papanicolaou (Pap) testing at the intersection of self-reported sexual minority (SM) status and race/ethnicity. Methods: Data from the National Health Interview Survey (2015 and 2018) were used to examine cervical cancer screening disparities. Natal females without a history of hysterectomy who were 21 to 65 years old and had reported their sexual orientation and Pap testing history were included. Demographic and health characteristics were summarized with descriptive statistics. To adjust for differences in confounding variables between groups, propensity score–based inverse probability of treatment weighting (IPTW) was performed. IPTW-adjusted multivariable logistic regression models estimated odds of ever undergoing a Pap test by sexual orientation alone and with race/ethnicity (non-Hispanic White, non-Hispanic Black, and Hispanic). Results: SM persons (n = 877) had significantly reduced odds of ever undergoing Pap testing (odds ratio, 0.54; 95% confidence interval, 0.42-0.70) in comparison with heterosexual persons (n = 17,760). When the intersection of sexual orientation and race/ethnicity was considered, non-Hispanic White SM participants and Hispanic SM participants had reduced odds of ever undergoing Pap testing in comparison with non-Hispanic White heterosexual participants. No significant differences were observed between non-Hispanic White heterosexual participants and participants of non-Hispanic Black SM or Hispanic heterosexual identities. Conclusions: SM participants were significantly less likely to have ever undergone a Pap test in comparison with heterosexual participants, with Hispanic SM participants having the lowest uptake. Future studies should further examine the roles of systemic discrimination and other key drivers of these disparities.
Bibliographical noteFunding Information:
This work was supported by the National Institutes of Health (T32CA163184, UL1TR002494, and P30CA77598). The funders had no role in the implementation of this study or in the presentation of the results.
Deanna Teoh reports grants from KCI/Acelity, Moderna, Jounce, and Tesaro/GSK outside the submitted work. Rachel I. Vogel reports grants to her institution from the American Cancer Society, the Melanoma Research Alliance, the National Institutes of Health, the Department of Defense, the Agency for Healthcare Research and Quality, and the Minnesota Ovarian Cancer Alliance and unpaid roles with the American Cancer Society Minnesota Researchers Committee and the Society of Gynecologic Oncology Publications Committee. The other authors made no disclosures. This work was supported by the National Institutes of Health (T32CA163184, UL1TR002494, and P30CA77598). The funders had no role in the implementation of this study or in the presentation of the results.
© 2022 American Cancer Society.
- cancer screening
- cervical cancer
- sexual minority