Alternative options for cervical cancer screening, such as self-sampling HPV tests, could increase screening uptake among transgender men, according to research results.
Transgender men are less likely to be screened for cervical cancer than cisgender women. About half of the transgender men surveyed reported they had not received a Pap smear within the past 3 years.
“This important study identifies factors, including HPV self-sampling, that may improve cervical cancer screening among transgender men with a cervix and translate into reduced cervical cancer morbidity and mortality in this population,” William Byne, MD, PhD, associate professor of psychiatry at Icahn School of Medicine at Mount Sinai in New York City, and editor-in-chief of LGBT Health, said in a press release.
HPV self-sampling tests for high-risk HPV — the primary cause of cervical cancer — and can be performed in any location as it does not include cytology, researchers wrote.
To determine whether this could be a viable primary screening alternative for transgender men who are uncomfortable with or lack access to conventional screening through a provider, investigators from University of Miami surveyed 91 self-identified transgender men aged 21 to 63 years (mean, 31.6 years) on their screening experiences and preferences.
About half (50.5%) of the population did not have a Pap smear in the prior 3 years as recommended by U.S. Preventive Services Task Force guidelines. Researchers found health insurance to be the only sociodemographic or health care experience variable associated with adequate screening (OR = 5.69; 95% CI, 1.49-21.66).
Additionally, after having the procedure described to them, 57.1% preferred HPV self-sampling over having a Pap smear, whereas 20.9% preferred a Pap smear, 14.3% had no preference, and 6.6% said they would refuse both options.
Individuals who reported having experienced discrimination by health care providers appeared more than three times as likely to prefer HPV self-sampling (OR = 3.29; 95% CI, 1.38-7.84).
The researchers cautioned that the results may not be representative of all transgender men as it is currently not possible to perform a population-based survey of randomly selected participants, given that national data sources do not include gender identity.
“Our findings suggest that significant cervical cancer screening disparities exist among transgender men, echoing the findings of previous inquiries,” the researchers wrote. “Although the incidence and prevalence of cervical cancer in this population are unknown
currently, disparities in screening may translate into disparities in cervical cancer morbidity and mortality among transgender men. Our findings suggest that HPV self-sampling may represent a viable strategy for improving cervical cancer screening among transgender men.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.