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Background <p>Disparities in up-to-date cervical cancer screening rates persist among women, including those identifying as lesbian, gay, bisexual or other sexual orientation (LGB+), highlighting the need for more inclusive and targeted screening interventions. With human papillomavirus at-home self-testing recently approved, we studied cervical cancer screening preferences by sexual orientation among persons assigned female at birth.</p> Methods <p>We examined cervical cancer screening preferences among a nationally representative sample of persons assigned female at birth aged 25–65 years in the 2024 Health Information National Trends Survey who did not self-report a history of cervical cancer. We assessed variation in preference for at-home self-testing or clinician-delivered cervical cancer screening by sexual orientation using weighted Rao-Scott chi-square tests and multivariate multinomial regression. We also examined reasons for preferring at-home self-testing.</p> Results <p>The analytical sample included 2,168 respondents. Most self-identified as heterosexual (88.43%) and preferred cervical cancer screening by clinicians (61.45%). Cervical cancer screening preferences differed by sexual orientation (<i>p</i> = 0.02). LGB+ versus heterosexual respondents more frequently preferred at-home self-testing (30.97% versus 19.53%), whereas heterosexual respondents more frequently preferred testing by clinician than their LGB+ counterparts (62.81% versus 50.38%). The odds of preferring at-home self-testing over clinician-delivered screening were higher among LGB+ versus heterosexual respondents (adjusted odds ratio = 2.04, 95% confidence interval = 1.17˗3.53), after adjusting for age, household annual income, marital status, health care utilization, race/ethnicity, and health insurance. The most frequently endorsed reason for preferring at-home self-testing was privacy (66.25%). Preferring at-home self-testing due to not taking time off work (35.22%), saving transportation cost (34.24%), and avoiding embarrassment (39.41%) were endorsed less frequently. Reasons for preferring at-home self-testing did not differ by sexual orientation.</p> Conclusion <p>LGB+ respondents more frequently preferred at-home self-testing compared to heterosexual respondents. These findings highlight the potential utility of at-home self-testing in addressing screening preferences and barriers among LGB+ persons.</p>

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Cervical cancer screening preferences by sexual orientation among persons assigned female at birth

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月17日

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  • Wei Yi Kong,
  • Jennifer L. St. Sauver,
  • Robert M. Jacobson,
  • Kathy L. MacLaughlin,
  • Lila J. Finney Rutten

摘要

Background

Disparities in up-to-date cervical cancer screening rates persist among women, including those identifying as lesbian, gay, bisexual or other sexual orientation (LGB+), highlighting the need for more inclusive and targeted screening interventions. With human papillomavirus at-home self-testing recently approved, we studied cervical cancer screening preferences by sexual orientation among persons assigned female at birth.

Methods

We examined cervical cancer screening preferences among a nationally representative sample of persons assigned female at birth aged 25–65 years in the 2024 Health Information National Trends Survey who did not self-report a history of cervical cancer. We assessed variation in preference for at-home self-testing or clinician-delivered cervical cancer screening by sexual orientation using weighted Rao-Scott chi-square tests and multivariate multinomial regression. We also examined reasons for preferring at-home self-testing.

Results

The analytical sample included 2,168 respondents. Most self-identified as heterosexual (88.43%) and preferred cervical cancer screening by clinicians (61.45%). Cervical cancer screening preferences differed by sexual orientation (p = 0.02). LGB+ versus heterosexual respondents more frequently preferred at-home self-testing (30.97% versus 19.53%), whereas heterosexual respondents more frequently preferred testing by clinician than their LGB+ counterparts (62.81% versus 50.38%). The odds of preferring at-home self-testing over clinician-delivered screening were higher among LGB+ versus heterosexual respondents (adjusted odds ratio = 2.04, 95% confidence interval = 1.17˗3.53), after adjusting for age, household annual income, marital status, health care utilization, race/ethnicity, and health insurance. The most frequently endorsed reason for preferring at-home self-testing was privacy (66.25%). Preferring at-home self-testing due to not taking time off work (35.22%), saving transportation cost (34.24%), and avoiding embarrassment (39.41%) were endorsed less frequently. Reasons for preferring at-home self-testing did not differ by sexual orientation.

Conclusion

LGB+ respondents more frequently preferred at-home self-testing compared to heterosexual respondents. These findings highlight the potential utility of at-home self-testing in addressing screening preferences and barriers among LGB+ persons.