Lesbian, bisexual women less likely to get cervical cancer screening
Lesbian and bisexual women in Chicago are less likely to be up to date on cervical cancer screening than heterosexual women, according to new research from the University of Illinois Chicago. But that gap narrows significantly when lesbian and bisexual women have a primary care provider.
The new study, published in JAMA Network Open, used survey data from the Chicago Department of Health from 2020-22 of over 5,000 cisgender women living in Chicago. The women were 25-64 years old and had no history of a hysterectomy. Being up to date on cervical cancer screening, a critical step in preventing the cancer, was defined as having been screened in the past three years.
Of the women who identified as heterosexual, 77% reported being up to date on the screening. Only 71% of those who identified as lesbian or bisexual said they were up to date.
Having a primary care provider made a difference for both groups, but the impact of that factor was larger for lesbian and bisexual women. Lesbian and bisexual women with a primary care provider were 93% more likely to be up to date on their screenings than lesbian and bisexual women without a primary care provider, nearly twice the difference in screening rates for heterosexual women.
“Having a primary care provider was more important for lesbian and bisexual populations than heterosexual populations,” said lead author Kelley Baumann, a research assistant in UIC’s Center for Research on Women and Gender who recently graduated with a master’s degree in public health from UIC.
The study didn’t explore why this was the case, but Baumann said other research has shown that LGBTQ+ people often have less stable health insurance than straight people. This means they may switch providers more frequently. When that happens, they may need to wait longer for an appointment, or their new doctor may not have access to medical records to see if they’re due for a screening. Additionally, given how intimate a cervical cancer screening is, some women are not comfortable getting screened by a doctor they don’t know well, Baumann said.
The study also broke down the difference in screening rates by race. For example, white women who identified as lesbian and bisexual were 5% less likely to report being up to date on the screening than heterosexual white women, but that gap grew to 15% for Black women.
These numbers didn’t surprise Baumann.
“Generally, we see that white LGBTQ folks fare better compared to their heterosexual counterparts, as opposed to when you’re looking at other racial or ethnic groups,” she said. This is commonly known as intersectionality, although the reason for this finding was not explored in this study.
The study’s findings underscore the importance of ensuring health care providers make all patients feel welcome and heard, Baumann said. She hopes the health care system becomes less fragmented so that switching providers is less likely to cause a delay in screenings.
The other UIC authors on the study from the School of Public Health, the College of Medicine and the University of Illinois Cancer Center are Caryn Peterson, Stacie Geller and Dr. Hunter Holt, who were joined by colleagues from the Chicago Department of Health and Brown University.
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