By Lauren Means
Cancer screening recommendations for the LGBTQ+ population are overall similar to those for the general population, as cancer risk factors and screening guidelines are often based on biological factors and epidemiological data. However, it’s important to consider the unique healthcare needs and disparities within the LGBTQ+ community. Individuals need to work closely with healthcare providers who are knowledgeable about LGBTQ+ health issues and can provide personalized care. Here are some general guidelines from the American Cancer Society.
Cervical Cancer Screening
The recommendation is that people with a cervix between the ages of 25 and 65 should get a primary HPV (human papillomavirus) test done every five years. If a primary HPV test is not available, a co-test (an HPV test with a Pap test) every five years or a Pap test every three years are also options.
People whose cervix has been removed by surgery for reasons not related to cervical cancer or serious pre-cancer should not be tested. However, people who have been vaccinated against HPV should still follow the screening recommendations for their age groups.
Given its invasive nature, Fenway Health has noted pap tests could cause body dysphoria for transmasculine people. This could be a deterrent from seeking cervical cancer screening. Their recommendation is to speak with your healthcare provider to see if a self-swab might be an option.
Breast Cancer Screening
People assigned female at birth who are 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so. From age 45 to 54 they should get mammograms every year. Once 55 and older they have the option to continue yearly screenings or decrease to every 2 years. Screening should continue as long as the individual is in good health and is expected to live 10 more years or longer.
Breast cancer can affect anyone, regardless of sex assigned at birth or gender identity. About one out of every 100 breast cancers diagnosed in the United States is found in someone assigned male at birth. Hormone therapy treatment could increase risk. Drugs containing estrogen — a hormone that helps develop and maintain female sex characteristics — can increase breast cancer risk.
Everyone should do self-screening at home and know how their breasts normally look and feel. Many changes or symptoms can also be caused by benign, non-cancerous conditions so it’s important to have any breast change checked by an experienced healthcare professional so the cause can be found and treated, if needed.
Colorectal Cancer Screening
Regular screening should begin at age 45 for those at average risk for colorectal cancer. This can be done with a stool-based test like Cologuard or with a colonoscopy which visually looks at the colon and rectum. Talk to your healthcare provider about which tests would be best for you and how frequently you should be screened.
Prostate Cancer Screening
Age 50 is when most people with a prostate should speak with their healthcare provider about the pros and cons of testing so they can decide if testing is the right choice for them.
If you are African American or have a father or brother who had prostate cancer before age 65, you are at a higher risk and should speak with your healthcare provider about screening at age 45.
Anal Cancer Screening
Since anal cancer is not prevalent in the United States, screening for the general public is not widely recommended at this time. However, in specific populations the risk is higher and individuals must be counseled on an individual basis.
These populations include people living with HIV, men who have sex with men (MSM), heterosexual individuals living with HIV, individuals with genital HPV-related dysplasia/cancer, individuals with genital warts, and anyone who is immunocompromised.
To date, the recommended screening is anal cytology testing (also known as an anal Pap test) followed by a digital rectal exam or a procedure called an anoscopy.
Since anal cancer screening is in the early stages, no set timeline recommendations have been set by the American Cancer Society.
Individual health needs can vary, and it’s important to have open and honest communication with your healthcare providers. LGBTQ+ individuals may face unique healthcare disparities, so working with providers who understand these issues is key to receiving appropriate and sensitive care.
*The preceding information is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it.
