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Chapter 38 - Screening Policies for Cervical, (Neo-)Vaginal, and Vulvar Dysplasia and Cancer

from Section G - Screening and Prophylaxis

Published online by Cambridge University Press:  22 December 2022

Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
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Summary

As medicine evolves, the traditional healthcare model that reflects societal binary systems is changing to become more inclusive of the transgender population. This is especially true in the field of gynecology and physicians have started to recognize the need for more research in the transgender population as it is particularly vulnerable due to healthcare disparities. Here, we conducted a literature review to help guide for gynecological cancer screening in the transgender population. We found that the transgender population is particularly at risk for infection with the human papilloma virus (HPV) and thus, should be encouraged to undergo preventative vaccination. In this chapter we will highlight screening policies in cervical cancer in the transgender male population, particularly for individuals who have not undergone gender-affirmation surgery. The rarity of vulvar and vaginal cancers in the transgender population have made it difficult to implement routine screening policies and patients should be screened on an individual basis in the presence of concerning symptoms. We also discuss screening skepticism in the transgender population and different techniques physicians can employ to improve their practice. It is our goal that through this chapter a physician can gain a deeper understanding and appreciation when caring for this unique patient population.

Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
, pp. 281 - 284
Publisher: Cambridge University Press
Print publication year: 2022

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References

Dhillon, N, Oliffe, JL, Kelly, MT, Krist, J. Bridging barriers to cervical cancer screening in transgender men: a scoping review. Am J Mens Health 2020;14(3):1557988320925691. https://doi.org/10.1177/1557988320925691CrossRefGoogle ScholarPubMed
McDowell, M, Pardee, DJ, Peitzmeier, S, et al. Cervical cancer screening preferences among trans-masculine individuals: patient-collected human papillomavirus vaginal swabs versus provider-administered pap tests. LGBT Health 2017;4(4):252259.Google Scholar
Arbyn, M, Weiderpass, E, Bruni, L, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Global Health 2020;8(2): e191e203.CrossRefGoogle ScholarPubMed
de Martel, C, Plummer, M, Vignat, J, et al. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int J Cancer 2017;141(4):664670.Google Scholar
Safaeian, M, Solomon, D, Castle, PE. Cervical cancer prevention – cervical screening: science in evolution. Obstet Gynecol Clin North Am 2007;34(4):739760. https://doi.org/10.1016/j.ogc.2007.09.004Google Scholar
Koh, W-J, Abu-Rustum, NR, Bean, S, et al. Cervical cancer, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2019;17(1):6484.CrossRefGoogle ScholarPubMed
Curry, SJ, Krist, AH, Owens, DK, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA 2018;320(7): 674686.Google Scholar
Reisner, SL, Deutsch, MB, Peitzmer, SM, et al. Comparing self- and provider-collected swabbing for HPV DNA testing in female-to-male transgender adult patients: a mixed-methods biobehavioral study protocol. BMC Infect Dis 2017;17:444.Google Scholar
Loughlin, KR. Cancer risk in the transgender community. Lancet Onc 2015;16(9):999.Google Scholar
Seay, J, Ranck, A, Weiss, R, et al. Understanding transgender men’s experiences with and preferences for cervical cancer screening: a rapid assessment survey. LGBT Health 2017;4(4):304309.Google Scholar
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 463: cervical cancer in adolescents: screening, evaluation, and management. Obstet Gynecol 2010;116(2 Pt 1):469472.CrossRefGoogle Scholar
Perkins, RB, Guido, RS, Castle, PE, et al. 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis 2020;24(2):102.CrossRefGoogle ScholarPubMed
Cooper, DB, Goyal, M. Colposcopy. StatPearls(online) 2020. See: www.ncbi.nlm.nih.gov/books/NBK564514/Google Scholar
Patel, JM, Dolitsky, S, Bachman, GA, et al. Gynecologic cancer screening in the transgender male population and its current challenges. Maturitas 2019;129:4044.Google Scholar
Grynberg, M, Fanchin, R, Dubost, G, et al. Histology of genital tract and breast tissue after long-term testosterone administration in a female-to-male transsexual population. Reprod Biomed Online 2010;20(4):553558.Google Scholar
Reisner, SL, Deutsch, MB, Peitzmeier, SM, et al. Test performance and acceptability of self- versus provider-collected swabs for high-risk HPV DNA testing in female-to-male trans masculine patients. PLoS One 2018;13(3):e0190172.CrossRefGoogle ScholarPubMed
Wright, TC Jr, Denny, L, Kuhn, L, Pollack, A, Lorincz, A. HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA 2000;283(1):8186. https://doi.org/10.1001/jama.283.1.81CrossRefGoogle ScholarPubMed
Greer, BE, Koh, WJ. New NCCN guidelines for vulvar cancer. J Natl Compr Canc Netw 2016; 14(5S):656658.CrossRefGoogle ScholarPubMed
Grosse, A, Grosse, C, Lenggenhager, D, et al. Cytology of the neovagina in transgender women and individuals with congenital or acquired absence of a natural vagina. Cytopathology 2017;28(3):184191.Google Scholar
Van Damme, P, Olsson, SE, Block, S, et al. Immunogenicity and safety of a 9-valent HPV vaccine. Pediatrics 2015;136(1):e28e39.CrossRefGoogle ScholarPubMed
Pils, S, Joura, EA. From the monovalent to the nine-valent HPV vaccine. Clin Microbiol Infect 2015;21(9):827833.CrossRefGoogle Scholar

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