Stirling Morgan, Bourque Michaela A, Hunter Mikayla, Queenan John, Ludwig Claire, Ristock Janice, Harrison Lyndsay, Ross-White Amanda, Nickel Nathan C, Schultz Annette, Banerji Versha, Gahagan Jacqueline, Mahar Alyson
Faculty of Health Sciences, Community Health Sciences, University of Manitoba Rady, Winnipeg, Manitoba, Canada.
Faculty of Health Sciences, College of Nursing, University of Manitoba Rady, Winnipeg, Manitoba, Canada.
Cancer Med. 2025 Aug;14(15):e70774. doi: 10.1002/cam4.70774.
Trans* and gender diverse people (TGD) are at risk of experiencing inequities across the cancer continuum. While limited evidence suggests cancer is a concern for TGD people, few systematic reviews or other knowledge syntheses exist that can guide efforts to improve the evidence base and address the inequities TGD people face in cancer care.
Our team conducted a mixed methods scoping review exploring how cancer affects TGD people. We extracted data on cancer type and phase of the cancer continuum, gender definition operationalization, results, and TGD engagement. We followed JBI's meta-aggregation approach for mixed methods reviews by qualitizing quantitative data through narrative interpretation and pooling to integrate the extracted data.
A search of multiple databases yielded 5986 titles after de-duplication. Reviewers independently screened titles and abstracts and identified 511 citations for full text review, and 55 were included for data extraction. Thirty studies reported on cancer screening, most of which focused on sex-based cancers. There was significant variation in terminology used to describe TGD people. We observed a lack of breadth in data used among included studies, limiting the generalizability of results. Six studies engaged TGD people. Few studies investigated cancer outcomes or experiences during the diagnosis and survivorship phases; few focused on survival or mortality outcomes.
We observed significant gaps in the body of research on TGD people and cancer. Efforts to improve the evidence base are needed to address knowledge gaps about TGD people's cancer experiences and outcomes and ensure the delivery of inclusive, evidence-based cancer care is possible.
跨性别者和性别多样化人群(TGD)在癌症连续过程中面临着不平等的风险。虽然有限的证据表明癌症是TGD人群所关注的问题,但很少有系统评价或其他知识综合研究能够指导相关工作,以改善证据基础并解决TGD人群在癌症护理中面临的不平等问题。
我们的团队进行了一项混合方法的范围综述,探讨癌症如何影响TGD人群。我们提取了关于癌症类型、癌症连续过程阶段、性别定义的操作化、结果以及TGD人群参与情况的数据。我们遵循JBI的混合方法综述的元聚合方法,通过叙事性解释对定量数据进行定性分析,并汇总以整合提取的数据。
对多个数据库进行检索,去重后得到5986个标题。评审人员独立筛选标题和摘要,确定了511篇文献进行全文评审,其中55篇被纳入数据提取。30项研究报告了癌症筛查情况,其中大部分聚焦于基于性别的癌症。用于描述TGD人群的术语存在显著差异。我们观察到纳入研究中使用的数据缺乏广度,限制了结果的普遍性。6项研究让TGD人群参与其中。很少有研究调查诊断和生存阶段的癌症结果或经历;很少有研究关注生存或死亡率结果。
我们观察到关于TGD人群与癌症的研究存在显著差距。需要努力改善证据基础,以填补关于TGD人群癌症经历和结果的知识空白,并确保提供包容的、基于证据的癌症护理成为可能。