Cervical cancer screening among sexual minority women: findings from a national survey

Purpose: Sexual minority women (SMW; lesbian, bisexual, and other women who have sex with women) are at risk for cervical cancer but less likely than non-SMW to receive regular cervical cancer screening (Pap- and/or HPV-testing). We examined factors contributing to receipt of guideline-based cervical cancer screening among SMW. Methods: During October 2019, we conducted an online survey of self-identified SMW aged 21–45 years living in the United States (n = 435). We estimated risk differences (RD) in women’s likelihood of being within current cervical cancer screening guidelines by sociodemographic and health-related characteristics. Results: Overall, 75% of respondents were within current screening guidelines. Adjusting for other factors, SMW were more likely to be within guidelines if they were insured (aRD 0.26, 95% CI 0.13, 0.39), had a partner (aRD 0.18, 95% CI 0.09, 0.28), and were older (aRD 0.12, 95% CI 0.04, 0.20). Overall, the most common reasons for not being screened recently were lack of insurance/cost (42%) and perceiving it was unnecessary (28%). Conclusion: Many SMW are not being screened for cervical cancer according to guidelines. Findings can inform efforts to improve screening among this population.