October 18, 2012

Lesbian Community Doesn’t Get Screened Enough For Cervical Cancer

Screening for cervical cancer was low among women who self-identified as lesbian – a finding that places them at a potentially elevated risk for the disease, according to data presented at the 11th Annual AACR International Conference on Frontiers in Cancer Prevention Research, held here Oct. 16-19, 2012.

"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. In fact, nearly 38 percent of lesbians in our study had not been screened according to recommended guidelines," said J. Kathleen Tracy, Ph.D., associate professor in the department of epidemiology and public health at the University of Maryland School of Medicine in Baltimore.

She and her colleagues conducted a standardized internet survey that examined recent cervical cancer screening behaviors and perceived screening barriers. They sent the survey to 3,000 self-identified lesbians in the United States and received 1,006 responses.

A total of 62 percent of the weighted sample underwent routine screenings. The most common reasons for lack of screening were no physician referral (17.5 percent) and absence of a physician (17.3 percent).

After adjustment for age, education, relationship status, employment status and insurance status, women who disclosed sexual orientation to their primary care physicians were 2.8 times more likely to undergo routine screening compared with women who did not disclose. Similarly, those who disclosed to their gynecologists were 2.3 times more likely to undergo routine screening.

"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," 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," Tracy 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."


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