Are lesbian and bisexual women at greater risk for cervical cancer?

We do not have enough information to know for sure. Lesbians and bisexual women may be at less risk of acquiring HPV if they have less sexual intercourse with men. However, many lesbians and bisexual women do or have had sexual intercourse with men. Furthermore, HPV is transmitted between women during sex.

There is evidence that lesbians and bisexual women are less likely seek routine health care because of the discomfort of coming out to health care providers and less access to health insurance. Additionally, because lesbian and bisexual women are less likely to need birth control, they are less likely to have regular gynecological check-ups and Pap tests. For these reasons, lesbians and bisexual women may be at greater risk for cervical cancer as precancerous cervical cell changes would be less likely to be detected at earlier, more treatable, stages.

Symptoms

Symptoms can include spots of blood on your underwear, pain during or bleeding after penetrative sexual activity and unusual vaginal discharges. Sometimes there are no symptoms until the cancer has progressed, underscoring the importance of regular Pap tests.

Diagnosis

The Pap test is simple, quick and usually not painful, although it may be uncomfortable. Your health care provider uses a speculum to hold open the vagina while swabbing the cervix to collect a sample of cells. These samples are then smeared on glass slides and sent to be examined under a microscope. Results are generally available in 1-2 weeks.

If your Pap test comes back with abnormal results, your doctor may perform a colposcopy (your cervix is examined through a device called a colposcope that magnifies the view of the cervix) and/or a biopsy. If these tests show cancer, further tests are necessary to determine if the disease has spread to other organs.

Treatment

Cervical cancer is treated primarily by surgery, radiation and chemotherapy. If the cancer is only on the outer wall of the cervix, doctors can often remove the area surgically with relative ease. If it has spread to the uterus or other organs, a hysterectomy or other surgery may be necessary. Radiation can also be very effective. Chemotherapy may be part of the treatment, if the cancer has spread.

How to reduce your risk for cervical cancer


Have a Pap test at age 18 (or when you become sexually active, whichever comes first) and every year for three years. If you have had three negative annual Pap tests in a row, your health care provider may recommend that you have it somewhat less often (every 2-3 years) depending upon your risk.


Try to limit your risk of contracting HPV, a virus that can cause cervical cancer, by limiting the number of your sexual partners and by delaying the age at which you become sexually active.


Don't smoke cigarettes.


Eat a diet high in fruits and vegetables and low in fat.