Baumann Kelley, Peterson Caryn E, Geller Stacie, Awadalla Saria, Holt Hunter K
University of Illinois College of Medicine Peoria, Peoria, IL, USA.
Department of Epidemiology and Biostatistics, University of Illinois Chicago, USA.
Prev Med. 2025 Feb;191:108223. doi: 10.1016/j.ypmed.2025.108223. Epub 2025 Jan 9.
Changes in up-to-date cervical cancer screening (CCS) over time by sexual orientation and race/ethnicity were estimated to identify trends in screening disparities.
This 2024 retrospective, cross-sectional analysis of National Health Interview Survey data (years 2013, 2015, 2019 and 2021) included 40,818 cisgender women aged 21-65 without hysterectomy. Joinpoint analysis was performed to calculate the annual percent change (APC) of up-to-date CCS from 2013 to 2021. Logistic regression (years 2019 and 2021) was used to describe the relationship between up-to-date screening and sexual orientation, race/ethnicity, and the interaction thereof.
The adjusted odds of up-to-date CCS were 22 % lower for lesbian, gay, and/or bisexual (LGB) compared to heterosexual women (OR = 0.78, p = 0.01). Up-to-date CCS fell significantly from 80.50 % in 2013 to 75.00 % in 2021 for heterosexual respondents (APC = -0.97 %, p < 0.01), but was stable across years for LGB respondents. Up-to-date CCS decreased for Hispanic (APC = -1.52, p < 01) and non-Hispanic White only heterosexual women (APC = -0.63, p = 0.02). It also decreased for non-Hispanic Black/African American only LGB women (APC = -2.67, p < 0.01) falling from 85.22 % in 2013 to 67.91 % in 2021. By multiplicative interaction, LGB Hispanic women were more up-to-date than their heterosexual counterparts (p = 0.05).
In 2021 there were approximately 19.72 million women aged 21-65 who were not up-to-date with CCS. 1.76 million LGB women were not up-to-date for CCS, and a greater proportion of these women identified as non-Hispanic Black/African American. CCS must be improved for all cisgender women, and specific attention should be given to those who identify as LGB and/or Black/African American.
通过性取向和种族/民族来估计宫颈癌最新筛查（CCS）随时间的变化，以确定筛查差异的趋势。
这项对2013年、2015年、2019年和2021年全国健康访谈调查数据进行的2024年回顾性横断面分析，纳入了40818名年龄在21至65岁之间且未进行子宫切除术的顺性别女性。进行连接点分析以计算2013年至2021年最新CCS的年度百分比变化（APC）。使用逻辑回归（2019年和2021年）来描述最新筛查与性取向、种族/民族及其相互作用之间的关系。
与异性恋女性相比，女同性恋、男同性恋和/或双性恋（LGB）女性最新CCS的调整后几率低22%（OR = 0.78，p = 0.01）。对于异性恋受访者，最新CCS从2013年的80.50%显著下降到2021年的75.00%（APC = -0.97%，p < 0.01），但LGB受访者多年来保持稳定。西班牙裔（APC = -1.52，p < 01）和仅非西班牙裔白人异性恋女性（APC = -0.63，p = 0.02）的最新CCS有所下降。仅非西班牙裔黑人/非裔美国LGB女性的最新CCS也有所下降（APC = -2.67，p < 0.01），从2013年的85.22%降至2021年的67.91%。通过乘法交互作用，LGB西班牙裔女性比其异性恋对应者更新（p = 0.05）。
2021年，约有1972万年龄在21至65岁之间的女性未进行最新的CCS。176万LGB女性未进行最新的CCS，其中很大一部分女性被认定为非西班牙裔黑人/非裔美国人。必须改善所有顺性别女性的CCS，应特别关注那些被认定为LGB和/或黑人/非裔美国人的女性。
