Cancer Screening Guidance

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. 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.

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.

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. In the absence of any past abnormalities on Pap tests, screening is generally recommended every three years. 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. 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.

If you have a prostate, you have some risk of developing prostate cancer. That said, as we reference on our general information page, prostate cancer 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. Please click here for more details.