Sexual-Orientation Differences in Breast and Cervical Cancer Screening in Louisiana, 2014-2024

Abstract Purpose To examine differences in up-to-date breast and cervical cancer screening between sexual minority (SM) and straight respondents in Louisiana and assess whether these differences varied across survey years and population characteristics. Methods We analyzed Louisiana Behavioral Risk Factor Surveillance System data from 2014, 2016, 2018, 2020, 2022, and 2024 among screening-eligible respondents classified as female in each annual dataset. Weighted descriptive analyses and log-binomial regression were used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) comparing SM with straight respondents and to assess heterogeneity across demographic, healthcare-access, and temporal characteristics. Results The cervical screening sample included 7,151 respondents and the breast screening sample included 8,325 respondents. SM respondents were more likely than straight respondents to report never having undergone cervical screening (25.2% vs 11.1%; P < 0.001), while never having undergone breast screening did not differ by sexual orientation (5.4% vs 3.5%; P = 0.284). Sexual-orientation differences in up-to-date screening varied by age, race and ethnicity, educational attainment, personal healthcare provider status, and survey year for both outcomes, but not by insurance status. The largest breast-screening difference was among respondents without a personal healthcare provider (PR = 0.56; 95% CI, 0.51–0.61). Screening patterns also varied across survey years and differed between breast and cervical screening. Conclusions Sexual-orientation differences in cancer screening in Louisiana varied across population characteristics, survey years, and screening outcomes. State-level surveillance that examines these differences beyond overall screening estimates can provide more specific evidence to inform cancer-screening efforts for SM populations.