Abstract
Introduction: Nearly all cervical cancer cases are caused by one of several high-risk strains of the human papillomavirus (hr-HPV). Transmasculine (TM) individuals (persons who have a masculine spectrum gender identity, but were recorded female at birth) have low adherence to standard cervical cancer screening modalities. Introduction of self-collected vaginal swabs for hr-HPV DNA testing may promote initiation and adherence to cervical cancer screening among TM individuals to narrow screening disparities. The purpose of this study was to assess the rate of cervical cancer screening among TM individuals following the introduction of self-collected swabbing for hr-HPV DNA testing in comparison to clinician-administered cervical specimen collection.Methods: Rates of uptake and adherence to cervical cancer screening among TM individuals were assessed before and after the clinical introduction of self-collected swab testing in October 2017. Rates were compared with the rates of cervical cancer screening among cisgender women at a colocated Comprehensive Health Program during the time period of review.Results: Of the 121 TM patients seen for primary care in the 6-month baseline period before the October 2017 introduction of self-collected swabbing for hr-HPV DNA testing, 30 (25%) had cervical cancer screening documented in the electronic medical record. Following the implementation of self-swabbing, of 193 patients, 98 (51%) had a documented cervical cancer screening, a two-fold increase in the rates of adherence to cervical cancer screening (p<0.001).Conclusion: Self-collected swab testing for hr-HPV can increase rates of adherence to screening recommendations among an otherwise under-screened population.
Highlights
Most cervical cancer cases are caused by one of several high-risk strains of the human papillomavirus
Of the 121 TM patients seen for primary care in the 6-month baseline period before the October 2017 introduction of self-collected swabbing for high-risk strains of the human papillomavirus (hr-HPV) DNA testing, 30 (25%) had cervical cancer screening documented in the electronic medical record
Cytology alone and hrHPV co-testing remain the predominant screening options recommended in clinical guidelines in the United States,[3,4] clinician-collected cervical swabs for primary hr-HPV screening is approved by the U.S Food and Drug Administration as an alternative strategy to cytology-based cervical cancer screening methods
Summary
Results: Of the 121 TM patients seen for primary care in the 6-month baseline period before the October 2017 introduction of self-collected swabbing for hr-HPV DNA testing, 30 (25%) had cervical cancer screening documented in the electronic medical record. Most cervical cancer cases are caused by one of several high-risk strains of the human papillomavirus (hr-HPV), leading to considerable morbidity and mortality in individuals with a cervix.[1] To date, there is a paucity of research surrounding cervical cancer screening in transmasculine (TM) individuals (persons with masculine spectrum gender identity but recorded female sex at birth) who retain cervix and uterus when compared to cisgender women (persons with feminine spectrum gender identity recorded female sex at birth).
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