Objectives: While health disparities affecting sexual minority women are well-documented globally, little is known about cancer screening behaviors among sexual minority women in Japan. Following our previous study on breast cancer screening, this study examined cervical cancer screening participation patterns and compared screening behaviors between both cancer types among sexual minority women in Japan.Methods: We analyzed data from 13,730 individuals with female sex assigned at birth who participated in a nationwide online survey between September and November 2023. Multinomial logistic regression was used to examine factors associated with screening participation, comparing sexual minority women (n = 2685) and women who are not part of a sexual minority (n = 11,045). Among participants aged 40 and above (n = 8933), we compared participation patterns between cervical and breast cancer screenings.Results: Sexual minority women showed significantly lower cervical cancer screening rates compared to women who are not part of a sexual minority (38.7% vs. 45.6%,p< 0.001), with a wider disparity than observed in breast cancer screening (43.4% vs. 45.9%,p< 0.001). Among those aged 40 and above, sexual minority women were more likely to skip both screenings (35.0% vs. 27.2%) and less likely to participate in both (55.0% vs. 62.6%). Additionally, our analysis revealed that participants with a current mental disorder (i.e., those reporting ongoing mental health issues) were more likely to intend to undergo cervical cancer screening (aOR = 1.39, 95% CI = 1.15–1.67,p= 0.001). In contrast, among bisexual participants and those classified as having “other” mental health conditions—defined as a history of mental health issues without current symptoms—exhibited significantly lower odds of being screened (aOR = 0.31, 95% CI = 0.11–0.82,p= 0.02).Conclusions: Significant disparities exist in cancer screening participation among sexual minority women in Japan, with more pronounced differences in cervical cancer screening compared to breast cancer screening. These findings highlight the need for targeted interventions addressing the unique barriers to gynecological care among sexual minority women.
目的：尽管全球范围内影响性少数女性的健康差异已有充分记录，但日本性少数女性的癌症筛查行为却鲜为人知。继先前关于乳腺癌筛查的研究后，本研究探讨了日本性少数女性宫颈癌筛查的参与模式，并比较了其在两类癌症筛查中的行为差异。 方法：我们分析了2023年9月至11月期间参与全国性在线调查的13,730名出生时性别为女性的个体数据。采用多项逻辑回归分析筛查参与的相关因素，比较性少数女性（n = 2685）与非性少数女性（n = 11,045）。在40岁及以上参与者（n = 8933）中，我们进一步比较了宫颈癌与乳腺癌筛查的参与模式。 结果：性少数女性的宫颈癌筛查率显著低于非性少数女性（38.7% vs. 45.6%，p < 0.001），该差异较乳腺癌筛查中观察到的差距更为显著（43.4% vs. 45.9%，p < 0.001）。在40岁及以上人群中，性少数女性同时回避两类筛查的比例更高（35.0% vs. 27.2%），同时参与两类筛查的比例更低（55.0% vs. 62.6%）。此外，分析显示当前存在精神障碍（即报告有持续心理健康问题）的参与者更倾向于接受宫颈癌筛查（aOR = 1.39，95% CI = 1.15–1.67，p = 0.001）。相比之下，双性恋参与者及被归类为具有“其他”心理健康状况（定义为有心理健康问题病史但当前无症状）的群体，其筛查概率显著降低（aOR = 0.31，95% CI = 0.11–0.82，p = 0.02）。 结论：日本性少数女性在癌症筛查参与方面存在显著差异，其中宫颈癌筛查的差异较乳腺癌筛查更为突出。这些发现表明，需要针对性地制定干预措施，以解决性少数女性在妇科保健领域面临的特殊障碍。
肿瘤(癌症)患者之家