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Review
. 2023 Oct 1;27(4):307-321.
doi: 10.1097/LGT.0000000000000763.

Understanding Sexual and Gender Minority Populations and Organ-Based Screening Recommendations for Human Papillomavirus-Related Cancers

Dominique Jodry  1 , Juno Obedin-Maliver  2 , Lisa Flowers  3 , Naomi Jay  4 , Serina Floyd  5 , Deanna Teoh  6 , Christine Conageski  1 , Levi Downs  7 , Michelle J Khan  2
Affiliations
Review

Understanding Sexual and Gender Minority Populations and Organ-Based Screening Recommendations for Human Papillomavirus-Related Cancers

Dominique Jodry et al. J Low Genit Tract Dis. .

Abstract

Objectives: Sexual gender minority (SGM) populations are at risk for human papillomavirus (HPV)-related cancers of the anogenital tract and oropharynx and often face barriers to health care. The goals of this document are to clarify language to provide inclusive care for SGM populations and to provide recommendations for screening and prevention of HPV-related cancers in SGM populations.

Materials and methods: An expert committee convened by the American Society for Colposcopy and Cervical Pathology performed a narrative review of the literature through February 2023. A comprehensive MEDLINE database search was performed for relevant studies. The literature review was divided into categories by organ/topic and by SGM population. Given the variability in available data for several of the categories, recommendations were made based on national guidelines where appropriate or expert opinion where there were less data to support risk-based guidelines.

Results: Definitions and terminology relevant to SGM populations are presented. The authors advocate the adoption of sexual orientation gender identity data collection and an organ-based screening approach, which is possible with knowledge of patient anatomy, sexual behaviors, and clinical history. This includes screening for cervical cancer per national recommendations, as well as screening for anal, vulvar, vaginal, penile, and oral cancers based on risk factors and shared clinical decision making. The authors recommend consideration of HPV vaccination in all SGM individuals up to age 45 years old who are at risk.

Conclusions: An organ-based screening approach is part of a global strategy to create an inclusive care environment and mitigate barriers to screening and prevention of HPV-mediated cancers in SGM populations.

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Conflict of interest statement

The authors have declared they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Annual incidence of HPV-associated cancers in the United States from the SEER Database, 2015–2019. Adapted from: Cancers associated with human papillomavirus, United States—2015–2019 USCS Data Brief, no. 31. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2022.
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