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Population based rates of Pap smear utilization among women in same-sex relationships

Julia E. Heck, MPH, MPhil, Epidemiology, ISERP Graduate Fellow, Columbia University, 270 International Affairs Bldg, MC3355, 420 W 118th St., New York, NY 10027, 212-854-6713, jeh61@columbia.edu and Randall L. Sell, ScD, Sociomedical Sciences, Columbia University, 722 West 168th Street, SPH/SMS 11th Floor, New York, NY 10032.

Background: Although many health providers perceive women who have sex with women (WSW) to be at low risk of contracting human papillomavirus (HPV) and developing cervical cancer, the majority of WSW report a history of sex with men. Given this risk, it is important to monitor rates of the Papanicolaou (Pap) smear in this population. However, few population-based data exist on rates of cancer screening among WSW. Methods: Using the pooled 2000 and 2003 National Health Interview Surveys, we identified persons ages 18-64 living in a same-sex relationship (SSR) or opposite-sex relationship (OSR). We used weighted chi-square tests to compare SSR and OSR subjects with respect to Pap smear use; we then used weighted logistic regression modeling to compare risk factors while controlling for age, race, educational attainment, income, and health insurance status. Results: The sample included 50 SSR and 7550 OSR women. Fewer SSR women reported ever having a Pap smear (92.5%) than OSR women (97.6%, P=0.03). SSR women were much less likely to report having a Pap smear in the prior 12 months (49.2%) compared to OSR women (70.2%, p=0.005). In multivariate analyses, SSR women were two-thirds less likely to have a recent (12-month) Pap smear (adjusted OR=0.35, 95% CI 0.18-0.66). Conclusions: WSW should be included in outreach programs to promote Pap smear use.

Learning Objectives:

Keywords: Cervical Cancer, Cancer Screening

Presenting author's disclosure statement:

Any relevant financial relationships? No

Lesbian and Bisexual Women's Health

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA