Sexual health Education: Are non-heterosexual women an 'at risk' group for cervical cancer?

Associate Professor Sonja Ellis is currently investigating whether non-heterosexual women are an 'at risk' group for cervical cancer. The project will run from October 2022 - 2024.

The Project

Cancer of the cervix (the entrance to the uterus from the vagina) is one of the most common forms of cancer. It is usually caused by the human papillomavirus (HPV) – a common sexually transmitted infection – and without prevention/intervention, cervical cancer has a high death rate. However, it is one of the easiest cancers to prevent, and regular cervical screening can reduce the risk of cervical cancer by 90% (health.govt.nz).

Despite potentially being at higher risk of cervical cancer than heterosexual women (Brown & Tracy, 2008) the findings of recent international research (Bustamante et al., 2021; Curmi et al., 2014; Milner & McNally, 2020) consistently indicate that non-heterosexual women (e.g., lesbians; wahine takatāpui; bisexual women) are much less likely to engage in cervical cancer screening than are women who primarily/exclusively have sex with men. This pattern has persisted for more than two decades and has been attributed to two overarching factors: heteronormativity in health care, and perceptions of risk among non-heterosexual women.

Engagement in cervical screening formed part of the NZ National Lesbian Health Survey (Saphira & Glover, 2000) but this research was undertaken more than 20 years ago and comprised a single research question. To date, no research undertaken in Aotearoa New Zealand has specifically focused on cervical screening in non-heterosexual women despite extensive studies being undertaken in other western contexts including the UK (Fish & Wilkinson, 2000; Hunt & Fish, 2008), Australia (Mooney-Somers et al., 2020), and Ireland (National Screening Service, 2021).

This research forms part of Dr Ellis' ongoing research programme around sexual health education, and is a one year project partially funded by a Small Scale Research Grant from the Waikato Graduate Women Educational Trust.

The aim of the study is to gather indicative baseline data about the extent to which non-heterosexual women aged 25-70 domiciled in Aotearoa/New Zealand engage in cervical cancer screening and the reasons they do, or do not, engage in this process. Its purpose is to gain a better understanding of the extent to which non-heterosexual women might be considered an ‘at risk’ group for cervical cancer. Drawing on critical and feminist health psychology perspectives (Fish, 2009; Lyons & Chamberlain, 2017) the study aims to identify ways in which non-heterosexual women who do not regularly engage in cervical screening might be encouraged to do so.

References

Brown, J. P., & Tracy, J. K. (2008). Lesbians and cancer: An overlooked health disparity. Cancer Causes Control, 19, 1009-1020.

Bustamante, G., Reiter, P. L., & McRee, A. L. (2021). Cervical cancer screening among sexual minority women: Findings from a national survey. Cancer Causes Control, 32(8), 911-917.

Curmi, C., Peters, K., & Salamonson, Y. (2014). Lesbians' attitudes and practices of cervical cancer screening: A qualitative study. BMC Women's Health, 14(1), 153-153.

Fish, J. (2009). Our health our say: Towards a feminist perspective of lesbian health psychology. Feminism & Psychology, 19(4), 437-453.

Fish, J., & Wilkinson, S. (2000). Lesbians and cervical screening: Preliminary results from a UK survey of lesbian health. Psychology of Women Section Review, 2(2), 5-15.

Hunt, R. & Fish, J. (2008). Prescription for change: Lesbian and bisexual women’s health check 2008. London: Stonewall.

Lyons, A. C., & Chamberlain, K. (2017). Critical health psychology. In B. Gough (Ed.), The Palgrave Handbook of Critical Social Psychology. Palgrave.

Milner, G. E., & McNally, R. J. (2020). Nonadherence to breast and cervical cancer screening among sexual minority women: Do stigma-related psychological barriers play a role? Health Psychology, 39(10), 891-899.

Mooney-Somers, J., Deacon, R. M., Anderst, A., Rybak, L. S. R., Akbany, A. F., Philios, L., Keeffe, S., Price, K., & Parkhill, N. (2020). Women in contact with the Sydney LGBTIQ communities: Report of the SWASH Lesbian, Bisexual and Queer Women’s Health Survey 2016, 2018, 2020. University of Sydney. https://www.acon.org.au/wp-content/uploads/2020/10/SWASH-Report-2020_Final.pdf

National Screening Service. (2021). LGBT+ cervical screening study. https://www.screeningservice.ie/publications/LGBT+Cervical-Screening-Study-Report.pdf

Saphira, M., & Glover, M. (2000). New Zealand National Lesbian Health Survey. Journal of the Gay and Lesbian Medical Association, 4(2), 49-56.