Meg Seymour, PhD
Regular cervical cancer screening is an important way to prevent cervical cancer or detect it while it is still in the early stages and can be treated more easily. Lesbians are less likely to get screened for cervical cancer than heterosexual and bisexual women, because many face barriers to accessing healthcare. For example, they are less likely than heterosexual women to have a primary healthcare provider and are more likely to have negative experiences with healthcare providers, such as feeling discriminated against.[3,4]
Another important reason why lesbians are not screened as often as other women is because many believe that they are less likely to get cervical cancer. Some lesbians are erroneously told by their healthcare providers that they do not need cervical cancer screenings due to not having sex with men. In fact, lesbians also develop cervical cancer and they have similar rates of cervical abnormalities to other women. Cervical cancer screening is recommended for all women with a cervix, with no exceptions.
Can lesbians get cervical cancer?
Almost all cervical cancer is caused by human papillomavirus, commonly referred to as HPV. HPV is the most common sexually transmitted infection (STI), and some strains of it can cause cancer. HPV usually goes away by itself without causing any harm, but if it does not go away it can cause cancer. For more information about HPV and other STIs, you can read this article. (STIs are sometimes referred to as sexually transmitted diseases [STDs].)
Some lesbians believe the myth that HPV can only be transferred through men’s bodily fluids, so they falsely believe that they cannot get HPV or develop cervical cancer. However, research has found that HPV can be transferred between women who are only having sex with other women: through contact between genitals, oral contact with genitals, digital contact with genitals, and sharing sex toys. The CDC notes that “the most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected.” However, for those who are not interested in abstinence or who do not have a monogomous long-term partner, it is important to practice safe sex.
Additionally, many lesbians have had sex with men earlier in their lives, and they may have been infected with HPV from those male partners. It can take as much as 10-20 years for a woman to develop cervical cancer after she was first exposed to HPV,[14,15] Lesbians are able to contract HPV from either past sexual experiences with men or from current experiences with female sexual partners.
Additional causes of cervical cancer
There is not conclusive research comparing the rate of cervical cancer among lesbians with the rate among other women. However, lesbians are more likely than heterosexual women to smoke, and smokers are twice as likely to get cervical cancer than non-smokers, because smoking makes it harder for the immune system to fight HPV.[14,16] If you are interested in information on how to quit smoking, you can read this article.
Lesbians are also more likely than heterosexual women to have an imbalance of good and bad bacteria in the vagina that is called bacterial vaginosis, and researchers have found that HPV is more common among women who have bacterial vaginosis. Bacterial vaginosis can sometimes lead to inflammation, causing health complications such as preterm birth or pelvic inflammatory disease. Bacterial vaginosis often does not cause any symptoms, but a common symptom is a “fishy” vaginal odor.
The bottom line
Lesbians should be sure to get the recommended cervical cancer screenings. Failure to have proper screening may delay a diagnosis of cervical cancer until the cancer has already progressed to a more advanced stage. This can lead to a greater likelihood of dying from the cancer.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
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- Centers for Disease Control and Prevention. What Should I Know About Screening? Cdc.gov. https://www.cdc.gov/cancer/cervical/basic_info/screening.htm. Updated August 2019.
- Takemoto ML, Menezes MD, Polido CB, Santos DD, Leonello VM, Magalhães CG, Cirelli JF, Knobel R. Prevalence of sexually transmitted infections and bacterial vaginosis among lesbian women: systematic review and recommendations to improve care. Cadernos de Saude Publica. 2019; 35:e00118118.
- McNair RP. Lesbian health inequalities: a cultural minority issue for health professionals. Medical Journal of Australia. 2003; 178(12):643-5.
- Tracy JK, Schluterman NH, Greenberg DR. Understanding cervical cancer screening among lesbians: a national survey. BMC Public Health. 2013 Dec 1;13(1):442.
- British Broadcasting Corporation. Lesbian women cervical screening myth is ‘dangerous’. Bbc.com. https://www.bbc.com/news/health-48802285#:~:text=The%20%22dangerous%20myth%22%20that%20gay,vast%20majority%20of%20cervical%20cancers.. 2019.
- Munson S, Cook C. Lesbian and bisexual women’s sexual healthcare experiences. Journal of Clinical Nursing. 2016; 25(23-24):3497-510.
- Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports. 2015; 64(RR-03):1.
- Centers for Disease Control and Prevention. Cancers Associated with Human Papillomavirus (HPV). Cdc.gov. https://www.cdc.gov/cancer/hpv/basic_info/cancers.htm#:~:text=Almost%20all%20cervical%20cancer%20is,cancer%20is%20caused%20by%20HPV. Updated November 2019.
- Centers for Disease Control and Prevention. Genital HPV Infection – Fact Sheet. Cdc. gov. https://www.cdc.gov/std/hpv/stdfact-hpv.htm. Updated August 2019.
- Curmi C, Peters K, Salamonson Y. Lesbians’ attitudes and practices of cervical cancer screening: a qualitative study. BMC Women’s Health. 2014; 14(1):2.
- Doull M, Wolowic J, Saewyc E, Rosario M, Prescott T, Ybarra ML. Why girls choose not to use barriers to prevent sexually transmitted infection during female-to-female sex. Journal of Adolescent Health. 2018; 62(4):411-6.
- Reiter PL, McRee AL. HPV infection among a population-based sample of sexual minority women from USA. Sexually Transmitted Infections. 2017; 93(1):25-31.
- McNair R. Risks and prevention of sexually transmissible infections among women who have sex with women. Sexual Health. 2005; 2(4):209-17.
- Waterman L, Voss J. HPV, cervical cancer risks, and barriers to care for lesbian women. The Nurse Practitioner. 2015 Jan 16;40(1):46-53.
- McGill University Division of Cancer Epidemiology. Facts about HPV. Mcgill.ca. https://www.mcgill.ca/hitchcohort/hpvfacts. 2020.
- American Cancer Society. Risk Factors for Cervical Cancer. Cancer.org. https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/risk-factors.html. Updated January 2020.
- Evans AL, Scally AJ, Wellard SJ, Wilson JD. Prevalence of bacterial vaginosis in lesbians and heterosexual women in a community setting. Sexually Transmitted Infections. 2007; 83(6):470-5.
- Liang Y, Chen M, Qin L, Wan B, Wang H. A meta-analysis of the relationship between vaginal microecology, human papillomavirus infection and cervical intraepithelial neoplasia. Infectious Agents and Cancer. 2019; 14(1):1-8.
- Mayo Clinic. Bacterial vaginosis. Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279. Updated May 2019.
- JK, Lydecker AD, Ireland L. Barriers to cervical cancer screening among lesbians. Journal of Women’s Health. 2010 Feb 1;19(2):229-37.