ORIGINAL RESEARCH
Kelley M. Baumann, MPH; Lauren Sayah, MPH; Destiny Strange; Caryn E. Peterson, PhD, MS; Stacie Geller, PhD; Hunter K. Holt, MD, MAS
Corresponding Author: Kelley M. Baumann, MPH; University of Illinois College of Medicine Peoria.
Email: kbauma22@uic.edu
DOI: 10.3122/jabfm.2025.250434R1
Keywords: Access to Care, Cancer Screening, Cervical Cancer, LGBTQ Persons, Papapinicolaou Test, Primary Care Physicians, Primary Health Care
Dates: Submitted: 11-14-2025; Accepted: 03-23-2026
Status: In Press.
INTRODUCTION: The US Preventive Services Task Force recommends cervical cancer screening for all people with a cervix aged 21-65. Prior research shows low cervical cancer screening rates among lesbian, gay, and bisexual cisgender women and older women (aged 50-65). Little is known about the screening rates of older lesbian, gay, and bisexual cis-women.
METHODS: Cross-sectional study of cis-women respondents to the National Health Interview Survey in 2013, 2015, 2019, 2021, and 2023 without history of hysterectomy or cervical cancer. We utilized odds ratios, logistic regression, interaction, mediation, and trend analysis to compare prevalence of up-to-date cervical cancer screening among older lesbian/gay/bisexual cis-women versus younger and/or heterosexual cis-women.
RESULTS: Among heterosexual cis-women, younger individuals reported 78% up-to-date cervical cancer screening and older individuals reported 72%. Among lesbian/gay/bisexual cis-women, younger individuals reported 71% up-to-date screening and older individuals reported 73%. In the adjusted logistic regression model, identifying as lesbian/gay/bisexual was associated with lower odds of up-to-date screening (Odds Ratio: 0.71, 95% CI 0.60, 0.84), as was older age (Odds Ratio: 0.67, 95% CI 0.61, 0.73). A usual place of care was associated with higher odds of up-to-date screening (Odds Ratio: 1.94, 95% CI 1.76, 2.14) and explained 65% (p<0.01) of the relationship between sexual orientation and screening.
CONCLUSION: Older lesbian/gay/bisexual cis-women reported similar screening rates as younger lesbian/gay/bisexual and older heterosexual cis-women, though screening across groups remains low. Access to a usual place of care improves screening for all, emphasizing the role of strong primary care to increase screening uptake.