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UBC Theses and Dissertations

Factors associated with cervical cancer screening in sexual and gender minority populations Chan, Candace

Abstract

Introduction Cervical cancer is the 13th most prevalent cancer in Canada and in 2017, there was an expected 1,550 new cases and 400 deaths related to cervical cancer. For cervical cancer screening, the BC Cancer Agency recommends that women between 25-69 years of age, be screened every 3 years. Population-based data has shown that cervical cancer screening rates are decreasing, and this is troublesome in sexual and gender minority (SGM) communities since these communities are at a higher risk for cervical cancer than their heterosexual counterparts. The purpose of this study is to identify factors associated with cervical cancer screening in the SGM community in British Columbia. Methods A mixed-methods cross-sectional survey was developed for this study. Participants who speak English, have access to the internet, were at least 21 years of age, reside in BC, have a cervix and self-identify as a member of the SGM community were included in this study. Results A total of 239 participants were included in this study and 81% of participants that were eligible to be screened based on BC Cancer screening guidelines, accessed screening. Participants who were eligible for screening were mainly white, had post-secondary education and lived in Vancouver, BC. From multiple logistic regression analyses, adjusted for age, BMI, culture and education, barriers associated with screening within recommended guidelines were self-identifying as asexual (AOR: 0.06; 95% CI: 0.01-0.040) and perceiving more barriers (AOR: 0.81; 95% CI: 0.74-0.89), whereas facilitators were not receiving poor service when using a telephone health line (AOR: 2.63; 95% CI: 1.01-7.14) and being health motivated (AOR: 1.13; 95% ci: 1.02-1.25). Analysis of qualitative data led to the identification of six themes as barriers (such as history of sexual assault, and gender dysphoria) and one theme, tailored services, as a facilitator. Conclusion While BC has sexual and gender inclusive guidelines for cervical cancer screening, barriers for accessing cervical cancer screening still exist and this needs to be addressed across all sectors, from health care providers to the SGM communities themselves.

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Attribution-NonCommercial-NoDerivatives 4.0 International