‘We're sexual somehow, but there are no risk factors': Cervical cancer screening in lesbians and women who have sex with women

Problem and Background: Cervical cancer death in women has declined by 50% in the United States due to Papanicolaou tests. Prevention requires screening and possible vaccination. Despite scientific strides, lesbians and WSW continue to have low screening rates. This can lead to late detection, resulting in early death.

Objective: This paper seeks to analyze low cervical cancer screening rates in lesbians and WSW. Health Care Providers’ (HCP) denial of tests, knowledge deficit of sexual health practices, and discriminatory attitudes are examined as barriers to screening access. Health beliefs among WSW such as “protective immunity” might contribute to misconceptions of sexual risk for cervical cancer. Finally, race as a factor in cervical cancer screening rates among WSW is evaluated.

Methods: I conducted a literature review of 28 articles through PubMed. Medical Subject Headings (MeSH) were key in obtaining scholarship on the HCP-patient relationship, WSW’s beliefs, and lower cervical cancer screening rates. “Lesbian” and “WSW” were utilized to recognize low screening populations regardless of identification or sexual history.

Conclusion: Distrust of the medical establishment was a prominent reason for not accessing screening. Lesbians and WSW were more likely to undergo cervical cancer screening when their HCP demonstrated awareness and offered testing. Education for HCPs and patients was important in cervical cancer screening engagement. WSW of color were underrepresented despite high mortality rates due to cervical cancer. Recruitment of black women was cited as a limitation in many studies. This is important in future cervical cancer studies especially in WSW of color.