Alexa L Solazzo1, Madina Agénor2, S Bryn Austin3, Jorge E Chavarro4, Brittany M Charlton5. 1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent, Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: alexa.solazzo@gmail.com. 2. Department of Community Health, Tufts University, Boston, Massachusetts; Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts; The Fenway Institute, Fenway Health, Boston, Massachusetts. 3. Division of Adolescent, Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 5. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent, Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Abstract
BACKGROUND: Although much has been published in recent years on differences in Papanicolaou (Pap) tests across sexual orientation, other aspects of cervical cancer prevention remain underexplored, such as human papillomavirus (HPV) vaccination, HPV co-tests, or abnormal Pap tests. METHODS: Data came from participants (aged 24-54 years) enrolled in an ongoing, longitudinal, U.S.-based cohort study, the Nurses' Health Study 3 (N = 12,175). Analyses were restricted to participants who met the current guidelines for care (e.g., ≥21 years of age for Pap tests). RESULTS: Mostly heterosexual women were more likely to initiate HPV vaccination than completely heterosexual women with no same-sex partners. All other comparisons across sexual orientation for HPV vaccination initiation and completion and the age of initiation were not statistically significant. Compared with completely heterosexual women with no same-sex partners, mostly heterosexual and lesbian women had lower odds of having a Pap test within the past 2 years. Completely heterosexual women with same-sex partners, mostly heterosexual women, and bisexual women had their first Pap test at an earlier age, had higher odds of having an HPV co-test, and had higher odds of having a positive HPV or abnormal Pap test compared with completely heterosexual women with no same-sex partners. In contrast, lesbian women had lower odds of having positive HPV or abnormal Pap results (odds ratio, 0.65; 95% confidence interval, 0.49-0.86) than completely heterosexual women with no same-sex partners. CONCLUSIONS: There are significant differences across sexual orientation groups in cervical cancer prevention for Pap test timing and positive HPV and abnormal Pap tests, but few differences in HPV vaccination initiation, completion, and age at initiation. Interventions should focus on increasing routine Pap testing among mostly heterosexual and lesbian women.
BACKGROUND: Although much has been published in recent years on differences in Papanicolaou (Pap) tests across sexual orientation, other aspects of cervical cancer prevention remain underexplored, such as human papillomavirus (HPV) vaccination, HPV co-tests, or abnormal Pap tests. METHODS: Data came from participants (aged 24-54 years) enrolled in an ongoing, longitudinal, U.S.-based cohort study, the Nurses' Health Study 3 (N = 12,175). Analyses were restricted to participants who met the current guidelines for care (e.g., ≥21 years of age for Pap tests). RESULTS: Mostly heterosexual women were more likely to initiate HPV vaccination than completely heterosexual women with no same-sex partners. All other comparisons across sexual orientation for HPV vaccination initiation and completion and the age of initiation were not statistically significant. Compared with completely heterosexual women with no same-sex partners, mostly heterosexual and lesbian women had lower odds of having a Pap test within the past 2 years. Completely heterosexual women with same-sex partners, mostly heterosexual women, and bisexual women had their first Pap test at an earlier age, had higher odds of having an HPV co-test, and had higher odds of having a positive HPV or abnormal Pap test compared with completely heterosexual women with no same-sex partners. In contrast, lesbian women had lower odds of having positive HPV or abnormal Pap results (odds ratio, 0.65; 95% confidence interval, 0.49-0.86) than completely heterosexual women with no same-sex partners. CONCLUSIONS: There are significant differences across sexual orientation groups in cervical cancer prevention for Pap test timing and positive HPV and abnormal Pap tests, but few differences in HPV vaccination initiation, completion, and age at initiation. Interventions should focus on increasing routine Pap testing among mostly heterosexual and lesbian women.
Authors: Brittany M Charlton; Heather L Corliss; Stacey A Missmer; A Lindsay Frazier; Margaret Rosario; Jessica A Kahn; S Bryn Austin Journal: Am J Public Health Date: 2013-06-13 Impact factor: 9.308
Authors: Madina Agénor; Ashley E Pérez; Sarah M Peitzmeier; Jennifer Potter; Sonya Borrero Journal: J Womens Health (Larchmt) Date: 2018-06-29 Impact factor: 2.681
Authors: Marion Doull; Jennifer Wolowic; Elizabeth Saewyc; Margaret Rosario; Tonya Prescott; Michele L Ybarra Journal: J Adolesc Health Date: 2017-12-28 Impact factor: 5.012
Authors: Madina Agénor; Sarah Peitzmeier; Allegra R Gordon; Sebastien Haneuse; Jennifer E Potter; S Bryn Austin Journal: Ann Intern Med Date: 2015-07-21 Impact factor: 25.391
Authors: Lauri E Markowitz; Eileen F Dunne; Mona Saraiya; Herschel W Lawson; Harrell Chesson; Elizabeth R Unger Journal: MMWR Recomm Rep Date: 2007-03-23
Authors: Madina Agénor; Sarah M Peitzmeier; Allegra R Gordon; Brittany M Charlton; Sebastien Haneuse; Jennifer Potter; S Bryn Austin Journal: Cancer Causes Control Date: 2016-08-09 Impact factor: 2.506
Authors: Michael J Herriges; Ruben Pinkhasov; Keren Lehavot; Oleg Shapiro; Joseph M Jacob; Thomas Sanford; Nick Liu; Gennady Bratslavsky; Hanan Goldberg Journal: Cancer Causes Control Date: 2022-09-09 Impact factor: 2.532
Authors: Ashley E Stenzel; Gabriela Bustamante; Courtney A Sarkin; Katherine Harripersaud; Patricia Jewett; Deanna Teoh; Rachel I Vogel Journal: Cancer Date: 2022-05-16 Impact factor: 6.921