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J Womens Health (Larchmt). 2010 Feb;19(2):229-37. doi: 10.1089/jwh.2009.1393.

Barriers to cervical cancer screening among lesbians.

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Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.



To evaluate cervical cancer screening practices and barriers to screening in a sample of lesbians.


Cross-sectional survey data were collected from 225 self-identified lesbians who completed an online questionnaire.


Of the respondents, 71% reported receiving a Pap screening test in the past 24 months (routine screeners), and 29% reported receiving a Pap screening test >24 months ago or never (nonroutine screeners). Routine screeners were more likely to be older (p < 0.01), white (p = 0.04), and college graduates (p < 0.01) than nonroutine screeners. Nonroutine screeners were more likely to delay seeking healthcare because of fear of discrimination (p < 0.01) and were less likely than routine screeners to disclose orientation to their primary care physician (p < 0.01). After adjusting for age, race, and education, nonroutine screeners perceived fewer benefits from (p < 0.01) and more barriers (p < 0.01) to Pap screening tests and were less knowledgeable about screening guidelines (p < 0.01) than routine screeners, but there was no difference in perceived susceptibility (p = 0.68), perceived seriousness (p = 0.68), or risk factor knowledge (p = 0.35) of cervical cancer.


Many lesbians do not screen for cervical cancer at recommended rates. Nonroutine screeners perceive fewer benefits, more barriers, and more discrimination and are less knowledgeable about screening guidelines than routine screeners.

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