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Why lesbians should be encouraged to have regular cervical screening
  1. Hazel J Henderson, MA, MFPH, Specialist Trainee in Public Health
  1. Public Health Department, Croydon Primary Care Trust, Croydon, UK
  1. Correspondence to Ms Hazel Henderson, Public Health Department, Croydon Primary Care Trust, 13th Floor, Leon House, 233 High Street, Croydon CR9 1XT, UK. E-mail: hazel.henderson{at}croydonpct.nhs.uk

Abstract

Introduction The UK National Health Service Cervical Screening Programme (NHSCSP) advice on cervical cytology screening states that women who have never had sex with men are at very low risk of developing cervical cancer, and advice regarding need for screening in lesbians is inconsistent.

Methods Literature review searching PubMed, Web of Science and the Internet for articles on lesbians, cervical cancer and cervical cancer risk factors focusing on human papillomavirus (HPV) and screening behaviours.

Results Case reports and prevalence studies show that HPV can be transmitted sexually between women. It is not known whether prevalence of HPV or cervical cancer differs between lesbians and heterosexual women. The evidence consistently shows that prevalence of non-attendance for cervical screening is much higher in lesbian than heterosexual women, which is linked to a belief that lesbians are less susceptible to cervical cancer and have less need for screening. Despite sharing most of the same risk factors as heterosexual women, lesbians are much less likely to undergo regular screening.

Conclusions The NHSCSP should take a clear and consistent stance on the need for cervical screening in lesbians. Both the health care and the lesbian communities must be made aware of the fact that regular cervical screening is as important in this group as it is in the heterosexual female population.

  • cervical cancer
  • cervical screening
  • human papillomavirus
  • lesbian
  • screening policy
  • Accepted August 19, 2008.

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