Manasnayakorn Sopark, Annoppornchai Pavinee, Laohavinij Wasin, Phanupak Nittaya, Suwan Ammarin, Suwajo Poonpissamai
Department of Surgery, Chulalongkorn University, Bangkok, Thailand.
Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand.
Int J Transgend Health. 2024 Feb 7;26(3):564-570. doi: 10.1080/26895269.2023.2299032. eCollection 2025.
Transgender women have higher rates of mortality associated with cancer diagnosis owing to inadequate transgender-specific cancer screening, leading to delayed diagnosis. Gender-affirming hormone therapy, age, and genetics are risk factors for breast cancer in transgender women. For transgender men, the risks were similar to those for cisgender women. However, population-based data on breast cancer screening and awareness among these sex groups are limited. This study aimed to assess breast cancer screening awareness, screening utilization, and factors associated with screening awareness among transgender individuals in Bangkok, Thailand. This multi-centered study included participants aged 18-80 years without a history of breast cancer. Data were collected using a structured questionnaire from October 2021 to October 2022. Sociodemographic data, hormonal use, gender affirming surgery, breast cancer screening awareness, utilization, and reasons for not undergoing screening were recorded. Associations with breast screening awareness were analyzed using multiple logistic regression analysis. In Bangkok, 402 transgender women and 333 transgender men were surveyed. Among them, 92.8% and 64.6% of the women and men groups, respectively, had received gender-affirming hormone therapy. The women group had a higher awareness of breast cancer screening (70.9%) than the men group (60.8%). However, only 4% and 17.1% of the women and men patients, respectively, underwent breast cancer screening. A history of gender-affirming hormone therapy use was associated with a higher likelihood of breast cancer screening awareness among women. Among the men, older participants who later underwent breast-reduction surgery had a family history of breast cancer, and other types of cancer were positively associated with higher breast cancer screening awareness. Although awareness of breast cancer screening among urban transgender individuals is high, multiple factors limit their access to breast cancer screening.
由于缺乏针对跨性别者的癌症筛查，导致诊断延迟，跨性别女性因癌症诊断而死亡的比率更高。性别确认激素疗法、年龄和基因是跨性别女性患乳腺癌的风险因素。对于跨性别男性，其风险与顺性别女性相似。然而，关于这些性别群体中乳腺癌筛查和知晓情况的基于人群的数据有限。本研究旨在评估泰国曼谷跨性别者中乳腺癌筛查的知晓情况、筛查利用率以及与筛查知晓相关的因素。这项多中心研究纳入了年龄在18 - 80岁且无乳腺癌病史的参与者。从2021年10月至2022年10月使用结构化问卷收集数据。记录社会人口统计学数据、激素使用情况、性别确认手术、乳腺癌筛查知晓情况、利用率以及未进行筛查的原因。使用多因素逻辑回归分析来分析与乳腺癌筛查知晓的相关性。在曼谷，对402名跨性别女性和333名跨性别男性进行了调查。其中，女性组和男性组分别有92.8%和64.6%接受了性别确认激素疗法。女性组对乳腺癌筛查的知晓率（70.9%）高于男性组（60.8%）。然而，分别只有4%的女性患者和17.1%的男性患者进行了乳腺癌筛查。使用性别确认激素疗法的病史与女性中更高的乳腺癌筛查知晓可能性相关。在男性中，年龄较大且后来接受了乳房缩小手术并有乳腺癌家族史以及其他类型癌症的参与者与更高的乳腺癌筛查知晓呈正相关。尽管城市跨性别者中对乳腺癌筛查的知晓率较高，但多种因素限制了他们获得乳腺癌筛查的机会。
