Cancer screening and management in the transgender population:Review of literature and special considerations for gender affirmation surgery  

作　　者：Juliet C Panichella Sthefano Araya Siddhartha Nannapaneni Samuel G Robinson Susan You Sarah M Gubara Maria T Gebreyesus Theresa Webster Sameer A Patel Alireza Hamidian Jahromi 

机构地区：[1]Lewis Katz School of Medicine,Temple University,Philadelphia,PA 19140,United States [2]Division of Plastic and Reconstructive Surgery,Fox Chase Cancer Center,Philadelphia,PA 19111,United States [3]Department of Plastic Surgery,Temple University,Philadelphia,PA 18045,United States [4]Division of Plastic and Reconstructive Surgery,Temple University Hospitals,Philadelphia,PA 19140,United States

出　　处：《World Journal of Clinical Oncology》2023年第7期265-284,共20页世界临床肿瘤学杂志（英文版）

摘　　要：BACKGROUND Literature focused on cancer screening and management is lacking in the transgender population.AIM To action to increase contributions to the scientific literature that drives the creation of cancer screening and management protocols for transgender and gender nonconforming(TGNC)patients.METHODS We performed a systematic search of PubMed on January 5th,2022,with the following terms:“TGNC”,OR“transgender”,OR“gender non-conforming”,OR“gender nonbinary”AND“cancer screening”,AND“breast cancer”,AND“cervical cancer”,AND“uterine cancer”,AND“ovarian cancer”,AND“prostate cancer”,AND“testicular cancer”,AND“surveillance”,AND“follow-up”,AND“management”.70 unique publications were used.The findings are discussed under“Screening”and“Management”categories.RESULTS Screening:Current cancer screening recommendations default to cis-gender protocols.However,long-term genderaffirming hormone therapy and loss to follow-up from the gender-specific specialties contribute to a higher risk for cancer development and possible delayed detection.The only known screening guidelines made specifically for this population are from the American College of Radiology for breast cancer.Management:Prior to undergoing Gender Affirmation Surgery(GAS),discussion should address cancer screening and management in the organs remaining in situ.Cancer treatment in this population requires consideration for chemotherapy,radiation,surgery and/or reconstruction.Modification of hormone therapy is decided on a case-by-case basis.The use of prophylactic vs aesthetic techniques in surgery is still debated.CONCLUSION When assessing transgender individuals for GAS,a discussion on the future oncologic risk of the sex-specific organs remaining in situ is essential.Cancer management in this population requires a multidisciplinary approach while the care should be highly individualized with considerations to social,medical,surgical and gender affirming surgery related specifications.Special consid

关 键 词：Gender affirmation surgery Gender affirming surgery Screening MANAGEMENT TRANSGENDER Gender diverse 

分 类 号：R730[医药卫生—肿瘤]