Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
LGBT Health. 2022 Jan;9(1):1-7. doi: 10.1089/lgbt.2020.0423. Epub 2021 Oct 19.
The purpose of this review was to compare differences in Papanicolaou (pap) test rates between sexual minority women (SMW) and heterosexual women. PubMed, Embase, and Scopus were searched from inception until June 2020 for articles reporting pap test rates among SMW. Studies were selected if they included pap test rates for SMW with a comparison rate for heterosexual women; studies were excluded if they did not report pap test rates. A quality assessment scale was used to assess study quality. A random-effects model was employed to calculate pooled odds ratios (ORs) for each outcome along with 95% confidence intervals (CI). Heterogeneity was assessed by implementation of the statistic, and L'Abbe plots were inspected visually to assess for homogeneity. Sensitivity analyses were performed by omitting each study sequentially and analyzing the overall impact of that study on the pooled results. Meta-regression was conducted to identify potential causes of heterogeneity among any statistically significant outcomes by an examination of the covariable of insurance coverage. We identified 21 cross-sectional studies comprising 24,207 SMW and 546,259 heterosexual women that met inclusion criteria. Overall, studies were of a fair quality. When compared with heterosexual women, SMW received less frequent pap tests (OR 0.58, 95% CI 0.48-0.71, 21 studies, 24,207 SMW, 546,259 heterosexual women). Compared with heterosexual women, lesbian women had routine pap tests less frequently (OR 0.46, 95% CI 0.37-0.56, 17 studies, 9595 lesbian women and 516,760 heterosexual women). Meta-regression for insurance status did not alter these results. SMW, in general, and lesbian women, in particular, receive pap tests less frequently than heterosexual women. The reasons for this disparity should be investigated to better serve the needs of this population. PROSPERO Registration: CRD#42020191887.
本综述的目的是比较性少数女性（SMW）与异性恋女性之间巴氏涂片（pap）检测率的差异。从建库到 2020 年 6 月，我们在 PubMed、Embase 和 Scopus 上检索了报告 SMW 巴氏涂片检测率的文章。如果研究包括了 SMW 的巴氏涂片检测率，并与异性恋女性的比较率进行了比较，则纳入研究；如果研究未报告巴氏涂片检测率，则排除研究。我们使用了一个质量评估量表来评估研究质量。采用随机效应模型计算每个结局的合并优势比（OR）及其 95%置信区间（CI）。通过实施 χ² 检验评估异质性，并通过 L'Abbe 图进行直观检查以评估同质性。通过依次剔除每个研究并分析该研究对汇总结果的整体影响，进行敏感性分析。通过检查保险覆盖范围这一协变量，对任何具有统计学意义的结果进行荟萃回归，以确定异质性的潜在原因。我们确定了 21 项符合纳入标准的横断面研究，共纳入 24207 名 SMW 和 546259 名异性恋女性。总体而言，研究质量为中等。与异性恋女性相比，SMW 接受巴氏涂片检测的频率较低（OR 0.58，95%CI 0.48-0.71，21 项研究，24207 名 SMW，546259 名异性恋女性）。与异性恋女性相比，女同性恋者进行常规巴氏涂片检测的频率较低（OR 0.46，95%CI 0.37-0.56，17 项研究，9595 名女同性恋者和 516760 名异性恋女性）。对保险状况进行荟萃回归并未改变这些结果。总体而言，SMW，尤其是女同性恋者，接受巴氏涂片检测的频率低于异性恋女性。应该调查这种差异的原因，以更好地满足这一人群的需求。PROSPERO 注册：CRD#42020191887。
