PCPs tied to cervical cancer screening adherence, regardless of sexual orientation

Key takeaways:

• Having a primary care provider was tied to being up to date on cervical cancer screening.
• Lesbian, gay or bisexual vs. heterosexual women with PCPs were more likely to be current on cervical cancer screening.

Having a primary care provider raises the likelihood of being up to date on cervical cancer screening, regardless of sexual orientation, but the association was greatest among lesbian, gay and bisexual women, according to researchers.

“LGBTQIA populations face unique barriers to cervical cancer screening; patients and practitioners often underestimate the risk of contracting high-risk HPV and therefore may not screen as often as recommended,” Kelley Baumann, BA, a graduate research assistant in the department of epidemiology and biostatistics at the Center for Research on Women and Gender at the University of Illinois, Chicago, and colleagues wrote in JAMA Network Open. “Although sexually minoritized populations have poorer health care access in Chicago, there is limited research on cervical cancer screening disparities for LGBTIA patients.”

Baumann and colleagues conducted a retrospective, cross-sectional, population-based study with data from 5,167 cisgender women aged 25 to 64 years living in Chicago who completed the Healthy Chicago Survey from 2020 to 2022. The women had no hysterectomy history and self-reported sexual orientation as heterosexual, lesbian, gay or bisexual. Researchers considered participants up to date on cervical cancer screening if they reported having a Pap test within the past 3 years.

Overall, 447 women self-identified as lesbian, gay or bisexual. A total of 71.14% of lesbian, gay or bisexual and 76.95% of heterosexual women reported previous cervical cancer screening. Compared with heterosexual women, lesbian, gay or bisexual women had a 10% lower prevalence of being up to date on cervical cancer screening (prevalence rate [PR] = 0.9; 95% CI, 0.82-1).

In the regression analysis, researchers observed that having a PCP was associated with being up to date on cervical cancer screening (PR = 1.43; 95% CI, 1.29-1.59). Among those with a PCP, lesbian, gay or bisexual women were 93% more likely to be up to date on cervical cancer screening compared with those without a PCP (PR = 1.93; 95% CI, 1.37-2.72).

“Our health system and subsequent research have a responsibility to explore ways to establish and maintain longitudinal relationships between lesbian, gay or bisexual patients and their PCPs,” the researchers wrote. “Qualitative research methods and culturally appropriate interventions are recommended to better understand and address disparities in screening between lesbian, gay or bisexual and heterosexual cisgender women in Chicago and the U.S.”