Cancer Screening Guidance
People of the 2SLGBTQI+ community are more likely to face barriers trying to access screening for common cancers and are more likely to experience adverse health outcomes as a result. We hope to create a safe space for members of this community so they have equitable access to cancer screening.
Words matter. We use the 2SLGBTQI+ abbreviation but recognize this may not capture the full community or identify a person's unique identity. Likewise, some of the language used when discussing medical terminology such as ‘breast’ instead of ‘chest’ may not resonate for everyone. We are always looking for areas to improve our interaction with the community - should you have any comments, please reach out to us via our Contact Form.
Breast / Chest Cancer Screening
For cis-gender women, recommended screening guidelines for breast cancer vary depending on a person’s age and risk factors.
In general, it is recommended that women aged 50-74 have a screening mammogram every two years. Women aged 40-49 and women aged 75 and older may benefit from ongoing screening depending on select circumstances.
For trans-women who have taken gender-affirming hormones like estrogen, screening may be recommended. Estrogen may carry an increased risk of breast cancer, so if you have taken estrogen for more than five years and are between the ages of 50 and 74, you may qualify for screening tests every two years.
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For trans-men who have not had top surgery and are between the ages of 50 and 74, it is recommended that you have chest screening every two years. If you have had top surgery, it may still be important to continue to monitor the health of your chest tissue.
Cervical Cancer / HPV Screening
The HPV virus is the root cause of 95% of all cases of cervical cancer. HPV is the most common virus affecting the genitourinary tract.
It can affect all persons shortly after they become sexually active. If you have ever had any genital skin-to-skin contact with another person of any gender and you have a cervix, then you are at risk of cervical cancer and screening is recommended starting at the age of 25.
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For trans-women who have had a vaginoplasty with a cervix created, then screening may also be appropriate. We have little data as to the full risk of cervical cancer for trans-women, but given the tissue involved in creating a neo-vagina and neo-cervix, there may be a risk of developing cancer of the neo-cervix. This risk will vary based on the individual and their past exposure to HPV.
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For trans-men who have not had bottom surgery or for trans-men who have had a hystrectomy and kept their cervix, then screening is still recommended. For trans-men who have had a hysterectomy including removal of their cervix, then further screening is likely no longer required. For those who have a history of past abnormal paps prior to surgery, then generally a smear of the vaginal vault is recommended and screening should be continued until you have three consecutive normal smears.
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BC is transitioning from Pap test to HPV testing as the primary screening method for cervical cancer. Cervix self-screening is recommended every five years for women and people with a cervix ages 25-69 (or every three years for those who are recommended to have a Pap test).
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Self-screening HPV tests can be requested direclty from BC Cancer - here
Unsure as to whether you are eligible or require a Pap Test? Please book an appointment for review a physician to review your needs - here.
*Currently, we can only offer Pap testing to those able to travel to Victoria for Testing.
Colon Cancer Screening
If you have a colon and are between the ages of 50-74, you generally qualify for colorectal cancer screening.
Sexual orientation or past gender-affirming treatments or surgeries typically does not affect recommendations for colon cancer screening.
Lung Cancer Screening
11% of Canadians smoke regularly. Smoking greatly increases the risk of lung cancer. Lung cancer screening is recommended to individuals who are:
1. Current or past smokers.
2. Are between 55-74 years old.
3. Have smoked for 20 years or more.
Prostate Cancer Screening & Surveillance
If you have a past diagnosis of prostate cancer we can provide Prostate-Specifc Antigen (PSA) testing surveillance and arrange appropriate follow-up investigations. Please book a cancer surveillance consultation.
If you have a prostate, you have some risk of developing prostate cancer however screening remains a controversial topic in the medical community. If you are a trans-woman who has had gender affirming surgery, then the way in which a prostate is examined is different. However, screening guidelines remain unchanged.
A blood test moniotring PSA is often wrongly described as a screening test. PSA is a protein made within the prostate of all men of reproductive age. Higher than normal levels of PSA found in the blood may indicate the presence of cancer, however it is not a marker of cancer and has many other causes.
When looking only at PSA levels, there is a risk of both "false positive" and "false negative" results that can cause confusion for both physicians and patients. In addition to this, many men will develop prostate cancer which poses little to no risk to their overall health. As such, people will often receive unnecessary investigations and treatments which carry risks such as impotence and incontinence which have their own effects on quality of life.
The British Columbian Medical Service Plan (MSP) does not cover routine PSA testing for 'screening' purposes. PSA testing can be completed at participating labs for a fee for 'screening' purposes. Please book an appointment to review your suitability for this test.
If you are experiencing any symptoms of an enlarged prostate such as weak urination, difficulty voiding, or nighttime awakening to void, please arrange a physical exam at a local clinic, Urgent Care Centre or Emergency Department.
