Pap smear avoidance places lesbian and bi women at risk of cervical cancer

Pap smear avoidance places lesbian and bi women at risk of cervical cancer

LAST UPDATED // Sunday, 03 May 2015 23:04 Written by // Cec Busby

Results from a new Australian study reveal lesbian and bi women are avoiding pap smears. Medical experts are warning this could leave them at higher risk of cervical cancer.

Lead researcher Julie Mooney Somers said routine pap smears are very successful at reducing risk of cancer and low testing rates amongst lesbians needed to be urgently addressed.

"The results of this study are concerning," said Mooney-Somers. "Routine Papanicolaou (Pap smear) tests have been very successful at reducing cervical cancer. Like all women, lesbian and bisexual women should be testing regularly. While we didn’t find the significant testing disparity between lesbian and heterosexual women reported in other countries, the lower rate of screening among women with no sexual history with men is something we need to address urgently.”

The study explored testing rates, changes in testing between 2002 and 2012, and predictors of test attendance among lesbian, bisexual and queer (LBQ) women in New South Wales.

It found that women who have never had sex with a man are 2.7 times less likely to have ever had a Pap smear. This is despite educational campaigns and Australian national guidelines stating all women who have ever had sex should have regular screening.

A relationship between STI testing and Pap smear testing was also shown.

“We’ve found that for a significant minority of lesbian and bisexual women, sexual or reproductive health is not part of their health care experience. Even if women have no need to discuss contraception with their GP, aren’t on the contraceptive pill for other reasons or don’t need testing for or advice on preventing STIs, we need to find other opportunities to talk about Pap smear tests,” said Mooney-Somers.

"More work is needed to understand why we have these lower rates of screening and what can be done to change it."

Cervical cancer is the second most prevalent cancer among women worldwide. In most western industrialised countries such as Australia, women are encouraged to have routine Pap smears, which identify pre-cancers before they can turn into invasive cancer.

The large majority of women diagnosed with invasive cervical cancer have not had regular Pap smear tests or were never screened.

The NSW incidence of cervical cancer has almost halved since the introduction of the NSW Cervical Screening Program in 1991 and mortality rates have decreased.



Cec Busby

Cec Busby

Cec Busby is the news editor of SX and online editor of

Comments (1)

  • EEB

    17 October 2014 at 20:26 |
    If we were serious about further reducing the incidence and mortality from this always rare cancer, we wouldn't be bothering with population pap testing, we'd offer HPV primary testing. This should also, include HPV self-testing for those who want to test but find the speculum exam unacceptable/painful etc.
    The evidence is clear, most women cannot benefit from pap testing, those HPV- and that's about 95% of women aged 30 to 60.
    HPV and pap testing is not recommended for those under 30 under an evidence based program and screening should stop at about 60.
    Australia has always seriously over-screened women, this provides no additional benefit to women, but means lots more false positives. We "treat" more than 10 times the women than a country like Finland.
    We've ignored the long standing evidence and as a result we have huge and hidden referral rates for colposcopy/biopsy and MANY end up over-treated. The lifetime risk of referral for colposcopy and at least a biopsy here is a huge 77%.
    The best program in the world IMO, for those who want to screen for this rare cancer (lifetime risk is 0.65%) is the new Dutch program, 5 HPV primary tests or use the self-testing device, the Delphi Screener, at ages 30,35,40,50 and 60 and only the roughly 5% who are HPV+ will be offered a 5 yearly pap test. (until they clear the virus)
    The new Australian program is likely to commence in 2016, but we'll stay with excess, 5 yearly HPV tests from 25 to 74 is not supported by the evidence. HPV testing is not recommended before age 30 and 5 HPV tests in total is sufficient. HPV self-testing will only be offered to those women who reject the invasive HPV test for 6 years, if you want to self-test, demand the Delphi Screener. You can now access this device through your GP or order it online.
    The language used in this article is also, inappropriate and disrespectful, all cancer screening is elective, our choice, to accept or demand as we see fit. We don't need an excuse or to plead our case. Find a doctor who'll respect your screening decisions. Note our GPs receive target payments for pap testing, a potential conflict of interest.
    The law and ethical standards says like men we must be permitted to make an informed decision about cancer screening, including pap testing.
    It should be a scandal that women are given poor medical advice and virtually ordered into testing, counted off like ignorant sheep and any information provided is IMO, biased in favour of screening, this should be a scandal. You also, cannot "avoid" something that is elective.
    I rejected the Australian program many years ago, I was not prepared to accept much risk at all to screen for a rare event, I was content with my near zero risk of cc, now I know I'm HPV- and cannot benefit from pap testing.
    There was never a need to worry and harm so many to help so few as Finland and the Netherlands have shown.
    be careful with breast screening as well, read the Nordic Cochrane Institute's summary on the website, the evidence is concerning. The NCI is an independent, not for profit, medical research group.
    HPV Today, Edition 24, sets out the new Dutch program.


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