Abstract PO-265: The intersection of sexual orientation with race and ethnicity in cervical cancer screening: Results from the National Health Interview Survey
Authors: Stenzel Ashley E. , Bustamante Gabriela , Sarkin Courtney , Harripersaud Katherine , Jewett Patricia , Teoh Deanna , Vogel Rachel I. 
Published: January 2022

Objectives: Cervical cancer screening is recommended for those with a cervix aged 21-65, with specific timelines dependent on individual risk. Persons belonging to sexual minority (SM) groups may experience greater risk factors for cancer while also being less likely to participate in cancer screening. We compared cervical cancer screening rates by sexual orientation, as well as intersectional analyses with race/ethnicity. Methods: Data from the NHIS years 2015 and 2018, were used to examine cervical cancer screening disparities. Biologic females without history of hysterectomy, ages 21-65 years, who reported sexual orientation and Pap testing history were included. Demographic, health, and cervical cancer screening characteristics were examined using descriptive statistics. Multivariable logistic regression models explored Pap testing rates by sexual orientation alone and with race/ethnicity (non-Hispanic (NH) white, NH Black, Hispanic), adjusting for age, partner status, education, health insurance, and poverty status. Results: SM participants (N=874) were younger, less likely to be living with a partner, had lower income, were less likely to have a medical clinic they go to for regular care, and more likely to delay their medical care due to costs, when compared to heterosexual counterparts (N=17,733). SM persons had significantly reduced odds of ever undergoing Pap testing (OR: 0.57, CI: 0.44-0.74) when compared to heterosexual persons. When considering the intersection of sexual orientation and race/ethnicity, heterosexual Hispanic, SM NH white, and SM Hispanic participants all had reduced odds of ever undergoing Pap testing when compared to NH white heterosexual participants. There were no significant differences observed between heterosexual and SM participants of NH Black or white identities. Conclusions: Participants identifying as SM were significantly less likely to have ever undergone a Pap test when compared to heterosexual participants. When stratifying by race/ethnicity, disparities remained for most participants identifying as SM. These results demonstrate a need for continued effort to increase Pap testing among the SM community. Further research is needed to further examine roles of systemic discrimination and other key drivers of these disparities.

Citation Format: Ashley E. Stenzel, Gabriela Bustamante, Courtney Sarkin, Katherine Harripersaud, Patricia Jewett, Deanna Teoh, Rachel I. Vogel. The intersection of sexual orientation with race and ethnicity in cervical cancer screening: Results from the National Health Interview Survey [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-265.