OBJECTIVE Sexual minority women are at heightened risk for breast and cervical cancer and are less likely than heterosexual women to obtain timely screenings for breast and cervical cancer. This study tested hypotheses about potential factors that contribute to nonadherence to these screenings among sexual minority women. METHOD Sexual minority women living in the United States aged 18 to 74 who met other eligibility criteria (n = 1,115) were recruited to complete an online questionnaire. Screening utilization, demographic information, sexual orientation, and health care indicators were collected. Variables linked to minority stress were assessed: stigma consciousness, internalized homophobia, rejection sensitivity, fear of negative evaluation, and concealment of sexual orientation from one's health care provider. Logistic regression models tested whether these psychological variables were independently associated with nonadherence for Papanicolaou (Pap) test and breast cancer screening. RESULTS The variable of concealment had the strongest positive independent association with failure to obtain timely Pap tests. Among women who had a general physical in the last year, concealment, stigma consciousness, rejection sensitivity, and fear of negative evaluation were all positively associated with lower rates of timely Pap tests. Among all women, these psychological variables were positively associated with never obtaining a Pap test and concealment was also negatively associated with clinical breast exam adherence. CONCLUSIONS Psychological barriers and concealment of sexual identity may hinder adherence to screening guidelines among some sexual minority women. Strategies facilitating positive experiences of disclosure to health care providers and addressing psychological factors related to minority stress could promote adherence. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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性少数妇女对乳腺癌和宫颈癌筛查的不依从性：与柱头有关的心理障碍是否起作用？

目的性少数族裔妇女患乳腺癌和子宫颈癌的风险更高，并且比异性恋妇女获得乳腺癌和子宫颈癌的及时筛查的可能性更低。这项研究检验了有关可能导致少数族裔女性不遵守这些筛查标准的假说。方法招募符合其他资格标准（n = 1,115），居住在美国的18至74岁的性少数族裔女性，以完成在线问卷。收集筛查利用率，人口统计学信息，性取向和卫生保健指标。评估了与少数群体压力相关的变量：柱头意识，内在的恐同症，排斥反应敏感性，害怕负面评估以及对医疗保健提供者隐瞒性取向。Logistic回归模型测试了这些心理变量是否与Papanicolaou（Pap）测试和乳腺癌筛查的不依从性独立相关。结果隐性变量与未能及时获得巴氏试验的正相关性最强。在去年身体一般的女性中，隐匿性，柱头意识，排斥敏感性和对阴性评估的恐惧都与及时巴氏检测的较低发生率呈正相关。在所有女性中，这些心理变量与从未获得Pap测试呈正相关，而隐瞒与临床乳房检查依从性也呈负相关。结论心理障碍和性身份的隐瞒可能会阻碍少数性少数妇女遵守筛查指南。促进向医疗保健提供者公开披露的积极经验并解决与少数群体压力有关的心理因素的策略可以促进依从性。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。