Abstract

Deaf, deafblind, and hard-of-hearing (DDBHH) American Sign Language (ASL) users assigned female at birth experience disparities in cervical cancer screening. There is a need to further clarify the roles of education status and English proficiency in adherence to the U.S. Preventive Services Task Force (USPSTF) screening guidelines. Using the NCI Health Information National Trends Survey in ASL, we surveyed participants; those who reported being female and within the USPSTF age-eligible range (21–65) were included in analyses. Associations were determined using Pearson Chi-squared tests. A two-sided p ≤ 0.05 was considered significant. Six hundred and forty-three participants, recruited between July 2023 and October 2025, answered questions in ASL and English, with 65% self-reporting screening adherence. Chi-square results indicated that more years of education were significantly associated with screening adherence [X2 (2) = 9.72, p = 0.008]. Consistent with the results, English proficiency was not a significant predictor of screening adherence [Fisher’s exact p = 0.267]. Those who self-report as HS graduates and/or have left college demonstrate lower adherence as well. These findings suggest that educational attainment may be an important factor associated with screening adherence among DDBHH ASL users and warrants further investigation in efforts to improve adherence toward Healthy People 2030 targets.

IPC Classification

Keywords