Braun Hayley, Nash Rebecca, Tangpricha Vin, Brockman Janice, Ward Kevin, Goodman Michael
Epidemiol Rev. 2017 Jan 1;39(1):93-107. doi: 10.1093/epirev/mxw003.
Transgender people comprise a diverse group of individuals whose gender identity or expression differs from that originally assigned to them at birth. Some, but not all, transgender people elect to undergo medical gender affirmation, which may include therapy with cross-sex hormones and/or surgical change of the genitalia and other sex characteristics. As cross-sex hormones administered for the purposes of gender affirmation may be delivered at high doses and over a period of decades, the carcinogenicity of hormonal therapy in transgender people is an area of considerable concern. In addition, concerns about cancer risk in transgender patients have been linked to sexually transmitted infections, increased exposure to well-known risk factors such as smoking and alcohol use, and the lack of adequate access to screening. Several publications have identified cancer as an important priority in transgender health research and called for large-scale studies. The goals of this article are to summarize the evidence on factors that may differentially affect cancer risk in transgender people, assess the relevant cancer surveillance and epidemiologic data available to date, and offer an overview of possible methodological considerations for future studies investigating cancer incidence and mortality in this population.
跨性别者是一个多样化的群体，他们的性别认同或表达方式与出生时最初被指定的性别不同。一些（但并非全部）跨性别者选择接受医学性别肯定治疗，这可能包括使用跨性别激素治疗和/或生殖器及其他性特征的手术改变。由于用于性别肯定目的的跨性别激素可能会高剂量使用且持续数十年，因此跨性别者激素治疗的致癌性是一个备受关注的领域。此外，对跨性别患者癌症风险的担忧与性传播感染、接触吸烟和饮酒等知名风险因素增加以及缺乏足够的筛查机会有关。一些出版物已将癌症确定为跨性别健康研究的重要优先事项，并呼吁进行大规模研究。本文的目的是总结可能对跨性别者癌症风险产生不同影响的因素的证据，评估迄今为止可用的相关癌症监测和流行病学数据，并概述未来研究该人群癌症发病率和死亡率时可能的方法学考虑因素。
