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Culturally safe, appropriate, and high-quality breast cancer screening for transgender people: A scoping review

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dc.contributor.authorRamsey, I.
dc.contributor.authorKennedy, K.
dc.contributor.authorSharplin, G.
dc.contributor.authorEckert, M.
dc.contributor.authorPeters, M.D.J.
dc.date.issued2023
dc.description.abstractBackground: There is a recognized need for evidence to inform breast cancer screening guidelines and services for transgender people, who face barriers to accessing appropriate and inclusive health care. Aims: This review summarized evidence for breast cancer risk and screening guidelines in transgender individuals, including the potential impact of gender-affirming hormone therapy (GAHT); factors that may influence screening decision-making and behaviors; and considerations for providing culturally safe, high-quality screening services. Methods: A protocol was developed based on the Joanna Briggs Institute scoping review methodology. Searches were performed in Medline, Emcare, Embase, Scopus, and the Cochrane Library for articles reporting information on the provision of culturally safe, high-quality breast cancer screening services for transgender people. Results: We identified 57 sources for inclusion: 13 cross-sectional studies, 6 case reports, 2 case series, 28 review or opinion articles, 6 systematic reviews, 1 qualitative study, and 1 book chapter. Evidence on rates of breast cancer screening among transgender people and the association between GAHT and breast cancer risk was inconclusive. Factors negatively associated with cancer screening behaviors included socioeconomic barriers, stigma, and lack of health provider awareness of transgender health issues. Breast cancer screening recommendations varied and were generally based on expert opinion due to the lack of clear evidence. Considerations for providing culturally safe care to transgender people were identified and mapped to the areas of workplace policies and procedures, patient information, clinic environment, professional conduct, communication, and knowledge and competency. Discussion: Screening recommendations for transgender individuals are complicated by the lack of robust epidemiological data and clear understanding of the role GAHT may play in breast cancer pathogenesis. Guidelines have been developed based on expert opinion and are subsequently not uniform or evidence based. Further work is required to clarify and consolidate recommendations.
dc.identifier.citationInternational Journal of Transgender Health, 2023; 24(2):1-21
dc.identifier.doi10.1080/26895269.2022.2155289
dc.identifier.issn2689-5269
dc.identifier.issn2689-5277
dc.identifier.orcidPeters, M.D.J. [0000-0002-1108-3783]
dc.identifier.urihttps://hdl.handle.net/11541.2/32604
dc.language.isoen
dc.publisherInforma UK Limited
dc.relation.fundingAustralian Government Department of Health
dc.rightsCopyright 2022 Taylor & Francis Group Access Condition Notes: Accepted manuscript available 01/04/2024
dc.source.urihttps://doi.org/10.1080/26895269.2022.2155289
dc.subjectbreast cancer
dc.subjectcultural safety
dc.subjectpopulation health
dc.subjectprevention
dc.subjectscreening
dc.subjecttransgender
dc.titleCulturally safe, appropriate, and high-quality breast cancer screening for transgender people: A scoping review
dc.typeJournal article
pubs.publication-statusPublished online
ror.fileinfo12268010090001831 13268010080001831 Open Access Postprint
ror.mmsid9916716729201831

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