To explore the willingness of women in Shanghai to participate in cervical and breast cancer screening (hereinafter referred to as " Two-cancer screening" ) and its influencing factors.

From January to June 2025, a two-stage mixed sampling method was adopted to select 779 women participating in the " Two-cancer screening" across 16 districts of Shanghai as research subjects. A field questionnaire survey was conducted using the self-designed Questionnaire on Standardized Management Path of Cervical and Breast Cancer Screening in Shanghai for Service Recipients (hereinaffter referred to as " the Survey Questionnaire" ). The Survey Questionnaire mainly covered four dimensions: ①general information of respondents; ②basic status of respondents′ participation in " Two-cancer screening" ; ③awareness level of respondents regarding prevention and treatment knowledge of the " Two-cancer screening" ; ④respondents′ willingness to underwent " Two-cancer screening". Based on the total score of willingness to underwent " Two-cancer screening", the respondents were divided into low willingness group (n=399, total score of willingness to underwent " Two-cancer screening" < 4 points) and high willingness group (n=380, total score of willingness to underwent " Two-cancer screening" ≥ 4 points). Independent-samples t test or chi-square test was used for statistical comparison of the questionnaire survey results between two groups. Variables with statistically significant differences in univariate analysis (P<0.05) were further included in multivariate unconditional logistic regression analysis to identify the influencing factors of women′s willingness to participate in the " Two-cancer screening". This study was reviewed and approved by the Medical Ethics Committee of Shanghai Municipal Center for Women and Children′s Health (Approval No. 2025-F003-001), and informed consent for the survey were obtained from all participants.

①A total of 800 questionnaires were distributed, and 779 valid questionnaires were recovered, with an effective recovery rate of 97.38%. ②Among the 779 respondents in this study, the satisfaction rates with screening items, procedures, environment and staff attitude of the " Two-cancer screening" service were 99.36% (774/779), 99.74% (777/779), 99.23% (773/779), and 99.36% (774/779), respectively; 97.56% (760/779) of respondents considered regular " Two-cancer screening" necessary. The main factors influencing respondents′ participation in " Two-cancer screening" were: their own health needs (56.48%, 440/779), the convenience of " Two-cancer screening" (38.90%, 303/779), and the screening cost (27.09%, 211/779). ③There were statistically significant differences between the low willingness group and high willingness group in terms of age, residential location, employment status, educational level, menstrual status, and per capita monthly household income (all P<0.05). Taking the willingness to participate in " Two-cancer screening" as the dependent variable and the statistically significant variables in univariate analysis as independent variables, multivariate unconditional logistic regression analysis showed that respondents residing in outer suburban areas (OR=0.652, 95%CI: 0.448-0.950, P=0.026), unemployed individuals (OR=0.418, 95%CI: 0.219-0.798, P=0.008), those with junior high school education or below (OR=0.413, 95%CI: 0.261-0.655, P<0.001), and those with per capita monthly household income of 2 000-4 999 yuan (OR=0.537, 95%CI: 0.321-0.897, P=0.018) or less than 2 000 yuan (OR=0.397, 95%CI: 0.190-0.831, P=0.014) had lower willingness to participate in the screening.

Unemployed women, those with low income or low educational attainment, and residents of outer suburban districts exhibit lower willingness to participate in " Two-cancer screening". These groups should be given more attention in the future.