意大利跨性别女性（AFAB）的宫颈癌一级和二级预防。
Primary and secondary prevention of cervical cancer among Italian AFAB transgender people.
机构信息
Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
出版信息
Curr Probl Cancer. 2024 Jun;50:101103. doi: 10.1016/j.currproblcancer.2024.101103. Epub 2024 May 13.
OBJECTIVE
Currently, available data on preventive measures for Human Papillomavirus (HPV) infection and cervical cancer in the transgender assigned female at birth (AFAB) community are extremely limited. Our aim was to analyze adherence to primary and secondary cervical cancer prevention screening programs among transgender AFAB people attending our gender clinic.
METHODS
Transgender AFAB people attending our center were recruited. Anamnestic data were collected for each person through completion of a medical history form and medical records. Variables recorded included previous HPV vaccination, adherence to regional screening programs (Pap smear or HPV DNA test), subject age, duration of current or prior gender-affirming hormone therapy (GAHT) and whether gender affirmation surgery (GAS) with hysterectomy had been performed. Open questions regarding reasons for not undergoing screening tests were also included.
RESULTS
In this cross-sectional study, 263 AFAB transgender people were included, with a mean age of 30.6 ± 10.5 years. GAS with hysterectomy had been performed on 37.6 % of these people. Of our participants, 71.7 % who were born after 1998 (the first cohort to receive HPV vaccination invitations in Italy) had been vaccinated for HPV. Seventy-four-point-nine percent of participants who were still eligible for cervical screening had never undergone Pap smear or HPV DNA testing, whereas those who had undergone at least one cervical screening had done so on average 4.2 ± 4.5 years ago.
CONCLUSION
HPV vaccination prevalence in the AFAB transgender population born after 1998 is in line with the Italian AFAB general population. However, adherence to cervical cancer screening programs in the transgender AFAB population appears to be lower in comparison to the cisgender population. Further efforts are required from the medical community to enhance AFAB transgender people's adherence to HPV vaccination and to cervical screening.
目的
目前，关于出生时被指定为女性的跨性别者（AFAB）群体中预防人乳头瘤病毒（HPV）感染和宫颈癌的可用数据极其有限。我们的目的是分析在我们的性别诊所就诊的跨性别 AFAB 人群中，对初级和二级宫颈癌预防筛查计划的依从性。
方法
招募了在我们中心就诊的跨性别 AFAB 者。通过填写病史表和病历，为每个人收集了病史数据。记录的变量包括以前的 HPV 疫苗接种、是否遵循区域筛查计划（巴氏涂片或 HPV DNA 检测）、受试者年龄、当前或以前的性别肯定激素治疗（GAHT）的持续时间以及是否进行了性别肯定手术（GAS）。还包括了关于未进行筛查测试的原因的开放性问题。
结果
在这项横断面研究中，共纳入了 263 名 AFAB 跨性别者，平均年龄为 30.6 ± 10.5 岁。其中 37.6%的人接受了 GAS 伴子宫切除术。我们的参与者中，71.7%的人出生于 1998 年以后（意大利第一批接受 HPV 疫苗接种邀请的人群），已经接种了 HPV 疫苗。仍有资格进行宫颈癌筛查的参与者中，74.9%从未接受过巴氏涂片或 HPV DNA 检测，而那些至少接受过一次宫颈癌筛查的参与者平均在 4.2 ± 4.5 年前进行了筛查。
结论
出生于 1998 年以后的 AFAB 跨性别者中的 HPV 疫苗接种率与意大利 AFAB 一般人群相符。然而，与 cisgender 人群相比，跨性别 AFAB 人群对宫颈癌筛查计划的依从性似乎较低。医疗界需要进一步努力，提高 AFAB 跨性别者对 HPV 疫苗接种和宫颈癌筛查的依从性。
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