Examining disparities in cervical cancer diagnosis at the intersection of disability and sexual orientation
Cervical cancer risk factors are more prevalent among women with disabilities and sexual minorities, yet little is known about how these factors intersect. To examine differences in cervical cancer diagnosis at the intersection of disability and sexual orientation. Using a nationally representative sample (N = 80,447) obtained from 2014 to 2023 National Health Interview Survey data, we conducted logistic regressions to estimate the odds of cervical cancer diagnosis at the intersection of disability and sexual orientation among women (25-65 years). We calculated three measures of interaction: 1) relative excess risk due to interaction (RERI); 2) proportion attributable to interaction (AP); and 3) synergy index (SI). Heterosexual women with disabilities were more likely to receive a diagnosis of cervical cancer (aOR = 2.15, 95 % CI: 1.75-2.64) compared to heterosexual women without disabilities. This disparity was even greater among women with disabilities who identified as sexual minorities (aOR = 2.98, 95 % CI: 1.86-4.77). The interaction measures suggest a synergistic effect between disability and sexual orientation on cervical cancer risk. Specifically, women with disabilities in multiple functional areas had increased odds of a cervical cancer diagnosis, regardless of sexual orientation (Heterosexual: aOR = 2.94, 95 % CI: 2.33-3.70; Sexual minorities: aOR = 3.04, 95 % CI: 1.25-7.42). The findings suggest that disability status plays a significant role in exacerbating the risk of cervical cancer, while the combination of disability and minority sexual orientation may further compound adverse experiences that disproportionately contribute to this risk.