Sexual orientation and time since last Papanicolaou test in Brazil: the 2019 National Health Survey.
In a cross-sectional analysis of 45,307 women in Brazil's 2019 National Health Survey, non-heterosexual women were less likely than heterosexual women to report a Papanicolaou test within the previous three years.
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In a cross-sectional analysis of 45,307 women in Brazil's 2019 National Health Survey, non-heterosexual women were less likely than heterosexual women to report a Papanicolaou test within the previous three years.
Research significance
The evidence identifies a cervical-cancer screening disparity rather than a treatment effect; it supports the inference that targeted, inclusive screening outreach might improve timely screening among homosexual and bisexual women, but no intervention or cancer outcome was tested.
Source abstract
This cross-sectional study used data from the 2019 National Health Survey to explore the association between sexual orientation and time since last Papanicolaou test in Brazil, by means of Poisson regression with robust variance, to estimate crude and adjusted prevalence ratios (PRs) and respective 95% confidence intervals (95%CI). The participants were 45,307 women, of whom 720 (1.85%) were non-heterosexual, that is, 394 (0.97%) homosexual and 326 (0.88%) bisexual. A negative association was found between sexual orientation and time of less than three years since last Papanicolaou test, among both women aged ≥18 years and those 25-64 years old (the target-population for cervical cancer screening in Brazil), with prevalences of, respectively, 17% (PR=0.83; 95%CI 0.76-0.90) and 14% (PR=0.86; 95%CI 0.78-0.96) lower among non-heterosexuals. That is, in Brazil, homosexual and bisexual women are less likely to have had a Papanicolaou test in the prior three years than heterosexual women, which calls for efforts by health services in Brazil to offer those women this important test.