{"title":"日本LGBTQ人群乳腺癌筛查率及影响因素","authors":"Akemi Hara, Akihiko Ozaki, Michio Murakami, Hiroaki Saito, Mika Nashimoto, Daisuke Hori, Masaharu Tsubokura, Kenji Gonda, Masahiro Wada, Kazunoshin Tachibana, Tohru Ohtake, Takahiro Tabuchi","doi":"10.1007/s12282-025-01669-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face significant health disparities worldwide, particularly in preventive medicine. In Japan, where breast cancer has the highest incidence rate among women, understanding screening behaviors among LGBTQ individuals is crucial for improving public health outcomes.</p><p><strong>Objective: </strong>This study aimed to elucidate the relationship between LGBTQ status and breast cancer screening behaviors in Japan, identifying factors influencing screening uptake and highlighting challenges in health management for the LGBTQ community.</p><p><strong>Methods: </strong>Using data from the Japan COVID-19 and Society Internet Survey (JACSIS), we analyzed breast cancer screening status among 11,056 biological females. Multinomial logistic regression and stratified regression analyzes were employed to examine factors associated with screening behavior, comparing LGBTQ and non-LGBTQ groups.</p><p><strong>Results: </strong>LGBTQ individuals demonstrated significantly lower odds of undergoing breast cancer screening (OR 0.82, 95% CI 0.73-0.91, p < 0.001) compared to non-LGBTQ individuals. Key factors influencing lower screening rates among individuals in the survey were primarily linked to LGBTQ identity, followed by higher rates of being uninsured, unmarried status, lower income levels, alcohol consumption. Stratified analysis revealed that uninsured LGBTQ individuals had significantly lower odds of screening (OR 0.23, 95% CI 0.08-0.70, p = 0.01) compared to those with national health insurance.</p><p><strong>Conclusion: </strong>This study identifies noteworthy differences in breast cancer screening behaviors between LGBTQ and non-LGBTQ individuals in Japan, as indicated by lower odds of screening participation among LGBTQ individuals, even after adjusting for socioeconomic factors. Findings underscore the need for targeted interventions, including improved healthcare access, LGBTQ-friendly medical environments, and awareness campaigns to address these disparities and promote health equity within the LGBTQ community.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"481-490"},"PeriodicalIF":2.9000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Breast cancer screening rates and influencing factors among LGBTQ groups in Japan.\",\"authors\":\"Akemi Hara, Akihiko Ozaki, Michio Murakami, Hiroaki Saito, Mika Nashimoto, Daisuke Hori, Masaharu Tsubokura, Kenji Gonda, Masahiro Wada, Kazunoshin Tachibana, Tohru Ohtake, Takahiro Tabuchi\",\"doi\":\"10.1007/s12282-025-01669-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face significant health disparities worldwide, particularly in preventive medicine. In Japan, where breast cancer has the highest incidence rate among women, understanding screening behaviors among LGBTQ individuals is crucial for improving public health outcomes.</p><p><strong>Objective: </strong>This study aimed to elucidate the relationship between LGBTQ status and breast cancer screening behaviors in Japan, identifying factors influencing screening uptake and highlighting challenges in health management for the LGBTQ community.</p><p><strong>Methods: </strong>Using data from the Japan COVID-19 and Society Internet Survey (JACSIS), we analyzed breast cancer screening status among 11,056 biological females. Multinomial logistic regression and stratified regression analyzes were employed to examine factors associated with screening behavior, comparing LGBTQ and non-LGBTQ groups.</p><p><strong>Results: </strong>LGBTQ individuals demonstrated significantly lower odds of undergoing breast cancer screening (OR 0.82, 95% CI 0.73-0.91, p < 0.001) compared to non-LGBTQ individuals. Key factors influencing lower screening rates among individuals in the survey were primarily linked to LGBTQ identity, followed by higher rates of being uninsured, unmarried status, lower income levels, alcohol consumption. Stratified analysis revealed that uninsured LGBTQ individuals had significantly lower odds of screening (OR 0.23, 95% CI 0.08-0.70, p = 0.01) compared to those with national health insurance.</p><p><strong>Conclusion: </strong>This study identifies noteworthy differences in breast cancer screening behaviors between LGBTQ and non-LGBTQ individuals in Japan, as indicated by lower odds of screening participation among LGBTQ individuals, even after adjusting for socioeconomic factors. Findings underscore the need for targeted interventions, including improved healthcare access, LGBTQ-friendly medical environments, and awareness campaigns to address these disparities and promote health equity within the LGBTQ community.</p>\",\"PeriodicalId\":56083,\"journal\":{\"name\":\"Breast Cancer\",\"volume\":\" \",\"pages\":\"481-490\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breast Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12282-025-01669-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12282-025-01669-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：女同性恋、男同性恋、双性恋、变性人和酷儿（LGBTQ）个体在世界范围内面临着显著的健康差异，特别是在预防医学方面。在女性乳腺癌发病率最高的日本，了解LGBTQ人群的筛查行为对改善公共卫生结果至关重要。目的：本研究旨在阐明日本LGBTQ状况与乳腺癌筛查行为之间的关系，确定影响LGBTQ群体接受筛查的因素，并强调LGBTQ群体健康管理面临的挑战。方法：利用日本COVID-19和社会互联网调查（JACSIS）的数据，分析11056名生物学女性的乳腺癌筛查情况。采用多项logistic回归和分层回归分析，比较LGBTQ组和非LGBTQ组筛查行为的相关因素。结果：LGBTQ个体接受乳腺癌筛查的几率明显较低（OR 0.82, 95% CI 0.73-0.91, p）。结论：本研究发现，日本LGBTQ个体与非LGBTQ个体在乳腺癌筛查行为上存在显著差异，即使在调整了社会经济因素后，LGBTQ个体参与筛查的几率也较低。研究结果强调了有针对性的干预措施的必要性，包括改善医疗服务的可及性、对LGBTQ友好的医疗环境，以及提高认识活动，以解决这些差异，促进LGBTQ社区内的健康公平。
Breast cancer screening rates and influencing factors among LGBTQ groups in Japan.
Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face significant health disparities worldwide, particularly in preventive medicine. In Japan, where breast cancer has the highest incidence rate among women, understanding screening behaviors among LGBTQ individuals is crucial for improving public health outcomes.
Objective: This study aimed to elucidate the relationship between LGBTQ status and breast cancer screening behaviors in Japan, identifying factors influencing screening uptake and highlighting challenges in health management for the LGBTQ community.
Methods: Using data from the Japan COVID-19 and Society Internet Survey (JACSIS), we analyzed breast cancer screening status among 11,056 biological females. Multinomial logistic regression and stratified regression analyzes were employed to examine factors associated with screening behavior, comparing LGBTQ and non-LGBTQ groups.
Results: LGBTQ individuals demonstrated significantly lower odds of undergoing breast cancer screening (OR 0.82, 95% CI 0.73-0.91, p < 0.001) compared to non-LGBTQ individuals. Key factors influencing lower screening rates among individuals in the survey were primarily linked to LGBTQ identity, followed by higher rates of being uninsured, unmarried status, lower income levels, alcohol consumption. Stratified analysis revealed that uninsured LGBTQ individuals had significantly lower odds of screening (OR 0.23, 95% CI 0.08-0.70, p = 0.01) compared to those with national health insurance.
Conclusion: This study identifies noteworthy differences in breast cancer screening behaviors between LGBTQ and non-LGBTQ individuals in Japan, as indicated by lower odds of screening participation among LGBTQ individuals, even after adjusting for socioeconomic factors. Findings underscore the need for targeted interventions, including improved healthcare access, LGBTQ-friendly medical environments, and awareness campaigns to address these disparities and promote health equity within the LGBTQ community.
期刊介绍：
Breast Cancer, the official journal of the Japanese Breast Cancer Society, publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research, seeking to develop a new focus and new perspectives for all who are concerned with breast cancer. The journal welcomes all original articles describing clinical and epidemiological studies and laboratory investigations regarding breast cancer and related diseases. The journal will consider five types of articles: editorials, review articles, original articles, case reports, and rapid communications. Although editorials and review articles will principally be solicited by the editors, they can also be submitted for peer review, as in the case of original articles. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.
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