Cytology and LGBT+ health: establishing inclusive cancer screening programs.
J Am Soc Cytopathol
; 11(5): 241-252, 2022.
Article
em En
| MEDLINE
| ID: mdl-35840516
ABSTRACT
There are substantial disparities in cancer screening for sexual minorities and gender non-conforming patients. In additional to patients having trauma due to negative experiences with the healthcare system, disparities may be heightened due to heteronormative and cisnormative design of screening programs and electronic medical record systems. Furthermore, there are morphologic challenges specific to certain specimen types from the LGBT + population, such as anal cytology samples, cervical cytology from transgender men taking testosterone, and neovaginal cytology samples. Men who have sex with men are at increased risk for anal cancer compared with the general population. While early detection of anal dysplasia decreases the risk of invasive carcinoma, screening programs are not widespread. Cervical cancer screening may be psychologically and physically challenging for transgender men and non-binary patients. The use of exogenous testosterone therapy causes atrophic changes in cervical cytology samples which mimic high-grade dysplasia. The rate of unsatisfactory samples are also increased in this population. Although HPV driven cancers have been reported in patients with neovaginas, there are currently no guidelines about appropriate screening for transgender women and intersex patients who have neovaginas. Cytopathologists can optimize the health of LGBT + patients in many ways including advocating for inclusive screening guidelines, validating self-collection for HPV and cytology samples, updating requisition forms to better capture the spectrum of gender expression, and recognizing the morphologic changes in cytology samples due to exogenous hormone use.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Atencao_primaria_forma_integrada
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Ânus
/
Neoplasias do Colo do Útero
/
Infecções por Papillomavirus
/
Minorias Sexuais e de Gênero
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Screening_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Am Soc Cytopathol
Ano de publicação:
2022
Tipo de documento:
Article