Study finds LGBTQ people less likely to get cervical-cancer screenings

An automated hand sanitizer station hangs outside of an exam room
An automated hand sanitizer station hangs outside of an exam room inside of North Memorial Hospital in Robbinsdale, Minn. on July 16, 2018.
Evan Frost | MPR News 2018

A new study finds that LGBTQ+ people, particularly those who identify as Hispanic, are less likely to undergo cervical cancer screenings.

A pap test, or pap smear, is a procedure where a small swab is used to brush cells from the surface of the cervix, according to the National Cancer Institute. Those cells can then be examined for abnormal cells that might indicated cancer growing, and types of human papillomavirus (HPV) which can cause multiple cancers including cervical.  

The research, which was done through the University of Minnesota, looked at data from the U.S. National Health Interview Survey, which collects health data through household interviews. They looked at participants who have a cervix and who were 21 through 65 years old, the recommended age window for pap tests. 

Researchers looked at responses from more than 20,000 people and found that sexual minorities — defined as “those whose sexual orientation differs from societal norms, including but not limited to those identifying as gay, lesbian, queer, bisexual, pansexual, and beyond” — were less likely to be screened.  

“And we found that this was more pronounced among people who identified as both Hispanic and belonging to a sexual minority population,” said Dr. Ashley Stenzel, a researcher at Allina Health in Minneapolis who co-authored the study. “This is really concerning for us, because cervical cancer screening is put in place because we want to identify this disease early on. So, we're looking for early signs of cervical cancer so that we can prevent having more severe disease and prevent deaths.” 

While the study did not determine why these disparities exist, Stenzel said systemic discrimination is likely a root cause.  

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“For example, people who come from a racial or ethnic minority population may be less likely to be recommended certain health screenings and cancer screenings, they may be less likely to be referred to specialty providers and they may be less likely to receive the same therapies as, say, a non-Hispanic white person would,” she said. 

Additionally, Stenzel said recent research she presented at the American Association for Cancer Research Conference which surveyed 310 people who identify as LGBTQ+ found significant experiences of discrimination in health care.   

“What was really alarming to us is that we found that almost half of our participants had experienced discrimination in the medical setting, meaning at like a doctor's appointment that was specifically related to either their sexual orientation or their gender identity,” she said. “So, I think it's very plausible that this could be shaping their health resource utilization.” 

The study also noted that Black Americans were overall less likely to undergo cancer screenings due to institutional discrimination, and that closer study of intersectionality in health care is needed. 

“It's really important to prevent deaths from this disease,” Stenzel said. “And if people don't know when they're supposed to undergo this screening, you can always book an appointment with a gynecologist.”  

Pap screenings are recommended for people with a cervix aged 21 through 65. Stenzel also stressed that people should speak to a medical provider about getting vaccinated against HPV.