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Tomohiro Mitoma,1 Jota Maki,1 Hikaru Ooba,1 Chikako Ogawa,1 Hisashi Masuyama,1 Takahiro Tabuchi2 1Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan; 2Department of Cancer Control Center, Osaka International Cancer Institute, Osaka, JapanCorrespondence: Jota Maki, Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan, Tel +81-86-235-7320, Fax +81-86-225-9570, Email jotamaki@okayama-u.ac.jpPurpose: Among the Organisation for Economic Co-operation and Development countries, Japan has one of the lowest cervical cancer screening coverages. Cancer screening coverage has worsened due to the coronavirus disease of 2019 (COVID-19) pandemic. This study investigated the relationship between socioeconomic background, COVID-19 infection history and vaccine status, and regular cervical cancer screening (CCS) during the two years of the COVID-19 era in Japan.Patients and Methods: We used data from the Japan COVID-19 and Society Internet Survey, a nationwide, Internet-based, self-report cohort observational study conducted in 2022. The outcome variable was identified by asking whether the participants had undergone CCS within the last two years. Cervical cytology was performed in Japan by brushing the external cervical os. This study used multivariate log-binomial regression models to evaluate inequalities during regular checkups for CCS. Adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) were estimated to incorporate the socioeconomic background variables.Results: Of the 12,066 participants, 5597 (46.4%) had undergone regular CCS for over two years. The prevalence ratio (PR) of patients who underwent CCS was 0.70 for those in their 20s and 0.78 for those in their 60s, compared to those in their 40s. Socioeconomic inequities were found in the following groups: unemployed/student, unmarried, high school graduate or lower, and household income below 4 million Yen. Our final multivariate analysis revealed that participants who were in their 20s or 60s, had a household income below 4 million Yen, were unmarried, had no annual health check-ups, and were unvaccinated with COVID-19 were at a higher risk of not undergoing CCS.Conclusion: The relationship between socioeconomic inequality and CCS hesitancy is prevalent among younger participants. The CCS coverage in Japan during the COVID-19 pandemic year (2020– 2022) was not low compared with the pre-pandemic era.Keywords: cervical cancer screening, social inequality, screening hesitation, internet survey

Kana Okuma, Kanako Kono, Machiko Otaka, Aya Ebara, Ayano Odachi, Hidetaka Tokuno, Hiroaki Masuyama Research and Development Division, Symbiosis Solutions Inc, Chiyoda-ku, Tokyo, 101-0064, JapanCorrespondence: Hiroaki Masuyama, Research and Development Division, Symbiosis Solutions Inc, 3F, VORT Suidobashi III Bldg, 2-8-11 Kandasarugakucho, Chiyoda-ku, Tokyo, 101-0064, Japan, Tel +81-3-6275-0878, Fax +81-3-6275-0879, Email masuyama@symbiosis-solutions.co.jpPurpose: The present study aimed to characterize the gut microbiota of individuals with premenstrual syndrome.Patients and Methods: The gut microbiota of 24 Japanese women with PMS (PMS group) and 144 healthy Japanese women (control group) were compared. Analysis of the α- and β-diversities and the gut microbial composition at the genus level were performed using 16S rRNA gene sequence data obtained from stool samples.Results: A significant difference in age was observed between the PMS and control groups; however, no significant difference was observed in BMI. The α-diversity measured using the Simpson index was significantly higher in the PMS group than the control group. Visualization of the β-diversity using non-metric multidimensional scaling and permutational multivariate analysis of variance (PERMANOVA) showed that the distance of the gut microbiota between the PMS and control groups is significantly different. Furthermore, a significant difference in the composition of the gut microbiota was observed between the PMS and control groups. At the genus level, the abundances of Collinsella, Bifidobacterium, and Blautia were significantly higher in the PMS group than in the control group. In particular, the abundance of Collinsella in the PMS group was approximately 4.5 times higher than that in the control group. To rule out the confounding effect of age in the abundances of Bifidobacterium, Blautia, and Collinsella, the gut microbiota of the PMS and control groups were compared by age group. Results showed that Collinsella had the highest effect size in participants of 30– 40 years of age (mean age: 36.39 ± 4.68 years).Conclusion: These results suggest that the PMS group possesses a characteristic gut microbiota. In particular, Collinsella was strongly associated with PMS. Since Collinsella has been reported to be associated with diet, dietary interventions such as prebiotics targeting Collinsella may be effective in preventing, improving, and alleviating PMS.Keywords: gut microbiota, 16S rRNA, premenstrual syndrome, Collinsella