Difference in Pap test uptake between women who have sex with women and other women in France: A comparative survey of 2032 women

Camille Poupon; Maud Poirier; Yuna Blum; Sandrine Lagarrigue; Cécile Parléani; Marie-Anne Vibet; Norbert Winer

doi:10.1016/j.pmedr.2022.101990

Difference in Pap test uptake between women who have sex with women and other women in France: A comparative survey of 2032 women

Prev Med Rep. 2022 Sep 19:30:101990. doi: 10.1016/j.pmedr.2022.101990. eCollection 2022 Dec.

Authors

Camille Poupon¹, Maud Poirier¹, Yuna Blum², Sandrine Lagarrigue³, Cécile Parléani¹, Marie-Anne Vibet⁴, Norbert Winer^{1

5}

Affiliations

¹ Medico-psychosocial Obstetrical and Gynecology unit (UGOMPS).
² Univ Rennes, CNRS, INSERM, IGDR (Institut de Génétique et Développement de Rennes) - UMR6290, ERL U1305, 35000 Rennes, France.
³ INRAE, INSTITUT AGRO, UMR1348 PEGASE, Saint-Gilles, 35590, France.
⁴ Methodology and Biostatistics Platform, Direction of Research and Innovation, University Hospital of Nantes, France.
⁵ Department of Gynaecology and Obstetrics, University Hospital of Nantes, NUN INRAE PhAN, UMR 1280, F-44000, France.

Abstract

The elimination of cervical cancer has been a priority of the World Health Organization since 2018. The number of these cancers induced by the human papillomavirus (HPV) could be drastically reduced through vaccination and regularly screening by Pap tests. Guidelines for cervical cancer screening apply to all women, including those who have sexual relations with women (WSW), as HPV can be transmitted during sex between two women. As far as we know, our study is the first that compare the Pap test rate between WSW and other women in France. We developed an 18-item questionnaire available on the internet for 15 days and finally analyzed the responses of 2032 women. Based on their responses about their self-definition of their sexual orientation and their sexual behavior, we classified them into three groups of women: exclusive WSW, mixed WSW, and non-WSW. For each question, we tested the statistical differences in responses between these three groups. Our study shows in a large sample representative of the French population that exclusive WSW undergo Pap tests significantly less often than either mixed WSW or non-WSW. Among the exclusive WSW, 28.9 % had never had a Pap test, compared with 9 % of the mixed WSW and 3.1 % of non-WSW (p < 0,001). The responses to our questionnaire contribute to an understanding of this disparity and thus help to envision solutions for better care of all women, regardless of their sexual orientation; this point is crucial for prevention of cervical cancer.

Keywords: Cervical cancer; Gynecology; HPV; Pap test; WSW.