Faculty Collaboration Database

Perceptions of Transgender and Nonbinary Persons Toward Breast and Cervical Cancer Development, Screening, and Potential Impact on Gender-Affirming Hormone Therapy. JCO Oncol Pract 2023 May;19(5):e794-e800

Date

02/18/2023

Pubmed ID

36800556

DOI

10.1200/OP.22.00681

Scopus ID

2-s2.0-85159542707 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

PURPOSE: Approximately 1.6% of adult Americans identify as transgender (TG) or nonbinary (NB) and many take gender-affirming hormone therapy (GAHT). Little data exist to inform breast and cervical cancer risks, gender-specific screening guidelines, and inclusive cancer treatment algorithms that consider GAHT. We aimed to assess TGNB persons' perceptions on breast and cervical cancer development, screening knowledge and practices, and attitude toward GAHT in the setting of a hormone receptor-positive breast cancer diagnosis.

METHODS: This single-institution survey study was conducted through an LGBTQ+ focused clinic from 2021 to 2022. Noncisgender patients age ≥ 18 years who were English speaking were eligible to participate. A 5-point Likert scale was used to assess concern of developing breast (all participants) and cervical cancer (those assigned female sex at birth). Demographic and quantitative variables were examined in comparison with responses via chi-squared tests.

RESULTS: Eighty-six participants completed the survey: 43% TG men, 24% TG women, and 20% NB persons. Most (84.9%) were age < 40 years, and 86% were non-Hispanic White. The majority were unaware of breast (77%) or cervical (60%) cancer screening recommendations for their sex assigned at birth or their gender. Approximately 35% reported concern regarding breast cancer development and of those age > 40 years; only 50% had undergone screening mammography. Of those assigned female sex at birth with an intact cervix, 47% were concerned about cervical cancer development and 46.6% had a Papanicolaou smear within the past 5 years. Nearly all (87.2%) were on GAHT, and 35.1% reported they would not consider stopping GAHT if diagnosed with a hormone receptor-positive breast cancer.

CONCLUSION: The findings support the need for patient and provider education on screening options and large prospective cohort data to elucidate optimal gender-specific screening guidelines and treatment algorithms.

UNLABELLED: [Media: see text].

Author List

Roznovjak D, Petroll AE, Lakatos AEB, Narayan R, Cortina CS

Authors

Chandler S. Cortina MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Raj Narayan MD Associate Dean, Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin
Andrew Petroll MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Breast Neoplasms
Early Detection of Cancer
Female
Hormones
Humans
Infant, Newborn
Male
Mammography
Prospective Studies
Transgender Persons
Uterine Cervical Neoplasms