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 highlights significant disparities in breast cancer screening behaviors between LGBTQ and non-LGBTQ individuals in Japan. 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.