ASPO Abstracts
Multi-level factors are associated with uptake of cervical cancer screening in Sexual and Diverse Adults Residing in Arizona
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Introduction: Despite availability of effective screening practices for early detection and prevention of invasive cervical cancer, emerging research suggests lesbian, bisexual, and transgender (LBT) individuals are less likely to undergo routine cervical cancer screening (CCS). Systematically examining factors for low CCS uptake in this population using a socioecological lens is key to designing and implementing effective interventions to reduce cancer-related death and disease. As the first step to this approach, the purpose of the study was to examine multi-level factors associated with CCS in LBT adults residing within the state of Arizona. Methods: Self-identified LBT adults with a cervix between the ages of 18-50 were invited to complete a one-time online survey assessing sociodemographic characteristics, health seeking practices, and CCS behaviors. Results: Of the 273 participants who completed the study; 62.5% identified as cisgender, 28.7% as transgender/gender nonconforming. Over 35% were gay/lesbian, and 30.8% identified as bisexual. Almost a quarter of participants reported never having received a Pap test. Fifty-four percent of all participants reported feeling uncomfortable discussing their health needs with a healthcare provider and over 60% were unsure of proactively asking their primary care provider for a Pap test. While 75% of participants who reported never receiving a CCS were sexually active in the past 12 months (a risk factor for cervical cancer), 53% were not sure if getting a Pap test was important (vs. 10% of those who received a CCS). Compared to those who had received a CCS, those who had never been screened had significantly lower cancer screening self-efficacy scores (t=5.18; p<.001) and were less likely to know someone in their social network who had received CCS (70% vs 38%; p<.001) suggesting that social norms may impact screening behaviors in this population. Conclusion: Interventions to increase CCS in this population may need to target proximal (knowledge, self-efficacy) and distal factors (social support, and strategies to improve provider communication strategies) while taking into consideration community-partnership guided participatory and implementation science approaches.
Keywords: Sexual and Gender Diverse Health, Health equity, cancer screening