Inequalities in cervical cancer screening participation in France: the role of sexual orientation, sexual practices, and history of violence

Introduction – Cervical cancer remains a major public health issue, although it is largely preventable through vaccination and screening. In France, despite the nationwide rollout of the National Organized Cervical Cancer Screening Program (PNDOCCU) in 2018, participation remains low and is marked by social and behavioral inequalities. Certain individual factors, such as sexual orientation, sexual practices, or a history of violence, which influence this participation, remain under-explored in French studies.Method – This study analyzes the individual determinants associated with screening participation among 3,481 women aged 25 to 65 who have ever had sexual intercourse. The data are drawn from the national survey Contexte des sexualités en France (CSF-2023). The variable of interest was having undergone a screening test in the past three years. Univariate analyses, followed by multivariate analyses adjusted for age, educational level, and perceived health, were conducted, supplemented by stratification according to relationship status.Results – In total, 81.9% of participants reported being up to date with their screening. In multivariate analyses, participation varied according to age, educational level, marital status, and several sexual dimensions: sexual activity in the past year, consideration of the importance of having a sex life for well-being, and oral-genital practices. Lower participation was observed among lesbian women and those who had experienced sexual violence. Conclusion – These results highlight the importance of intimate aspects rarely studied in France and call for adapting messages and professional practices to improve screening equity.

Author(s): Audiger Céline, Barré Stéphanie, Rigal Laurent

Publishing year: 2026

Pages: 274-280

Weekly Epidemiological Bulletin, 2026, n° 12-13, p. 274-280

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