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. 2022 Mar 1;45(3):116-121.
doi: 10.1097/COC.0000000000000893.

Breast and Cervical Cancer Screening Disparities in Transgender People

Oluwadamilola T Oladeru  1   2 , Sung Jun Ma  3 , Joseph A Miccio  4 , Katy Wang  5 , Kristopher Attwood  5 , Anurag K Singh  3 , Daphne A Haas-Kogan  2 , Paula M Neira  6
Affiliations

Breast and Cervical Cancer Screening Disparities in Transgender People

Oluwadamilola T Oladeru et al. Am J Clin Oncol. .

Abstract

Objectives: The population of individuals who identify as transgender (TG) is increasing in the United States, yet disparities in cancer screening services are widening. It is imperative that interpersonal and systemic barriers to cancer care are identified and removed for this vulnerable population. Our study sought to examine the difference in self-reported breast and cervical cancer screening rates between TG and cisgender (CG) people.

Materials and methods: Cross-sectional data from the 2014 to 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) was obtained on individuals who identified as CG or TG (male-to-female [MTF] and female-to-male [FTM]), including their responses to questions regarding breast and cervical screening history and their primary care access and associated barriers.

Results: Compared with the CG population, TG participants were less likely to adhere to or have undergone breast (FTM: odds ratio [OR] 0.47 and 0.32; MTF: OR 0.04 and 0.02, respectively; all P<0.001) and cervical cancer (FTM: OR 0.42 and 0.26, respectively; all P<0.001) screening. They were also less likely to have a primary care physician (FTM: OR 0.79; MTF: OR 0.58; all P<0.001) and less likely to seek primary care within a year owing to medical costs (FTM: OR 1.44; MTF: OR 1.36; all P<0.001).

Conclusions: Disparities exist in the uptake of routine cancer screening in the TG population despite their increased risk for breast and cervical cancer. Interventions are urgently needed to mitigate delays to cancer screening, close gaps in provider and patient knowledge about cancer screening, and improve health care experiences of gender minorities in the United States.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Forest plot on adherence to breast and cervical cancer screening. The odds ratio was adjusted for age, race, ethnicity, education level, income, health insurance, smoking status, and comorbidities. Abbreviations: OR: odds ratio; CI: confidence interval
Figure 2.
Figure 2.
Forest plot on access and barrier to primary care. The odds ratio was adjusted for age, race, ethnicity, education level, income, health insurance, smoking status, and comorbidities. Abbreviations: OR: odds ratio; CI: confidence interval
See this image and copyright information in PMC

References

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