Lesbian women less likely than heterosexuals to get annual pap smears

Lesbian women are less likely than heterosexual and bisexual women to get timely pap smears, according to a new paper from sociologists at Rice University.

“Cancer-Screening Utilization Among U.S. Women: How Mammogram and Pap-Test Use Varies Among Heterosexual, Lesbian and Bisexual Women” examines the relationship between cancer tests and sexual orientation among 2,273 lesbian, 1,689 bisexual and 174,839 heterosexual women interviewed in 15 U.S. states between 2000 and 2010.

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The researchers examined two cancer-screening measures: timely mammogram and pap tests, defined as having had a mammogram in the past two years for women aged 40 and older and having had a pap test in the past three years for women aged 21-65. Mammograms and pap smears are used to screen for breast and cervical cancer, respectively.

While the study’s results showed that rates of timely mammograms did not differ significantly by sexual orientation, lesbian women were 25 percent less likely than heterosexual and bisexual women to have timely pap smears (after adjusting for socio-economic status).

Alexa Solazzo, a graduate student in the Department of Sociology at Rice and the study’s lead author, said a possible explanation for the results may be linked to birth control. Women who use contraceptives are often required by doctors to have annual pap smears.

“Many doctors require women who seek a birth-control prescription to have had a recent pap test,” Solazzo said. “Women who don’t have sex with men might theoretically have less of a need for birth control than women who do have sex with men (i.e., heterosexual or bisexual women). Thus, they may be less likely to seek care at an OB-GYN and receive a pap test.”

Solazzo said she hopes that this research will encourage more studies on sexual-minority health disparities and contribute to a change in preventive health communication regarding the promotion of pap smears, emphasizing the importance of having these exams regardless of sexuality.

“A straightforward change to the public health message women receive that focuses less on sexual activity and more on the long-term health benefits of pap-smear testing may improve health overall and help reduce differences by sexual orientation,” she said.

The study will appear in an upcoming edition of Population Research and Policy Review and was co-authored by Bridget Gorman and Justin Denney, sociology professors at Rice. It is available online at http://link.springer.com/article/10.1007/s11113-017-9425-5.