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10-07-2015 | Gynecologic cancers | Article

Cervical Cancer Screening for Patients on the Female-to-Male Spectrum: a Narrative Review and Guide for Clinicians

Journal of General Internal Medicine

Authors: MD Jennifer Potter, MSPH Sarah M. Peitzmeier, BA Ida Bernstein, ScD, MA Sari L. Reisner, MPH, MPhil Natalie M. Alizaga, ScD, MPH Madina Agénor, BS Dana J. Pardee

Publisher: Springer US


Guidelines for cervical cancer screening have evolved rapidly over the last several years, with a trend toward longer intervals between screenings and an increasing number of screening options, such as Pap/HPV co-testing and HPV testing as a primary screening. However, gynecological recommendations often do not include clinical considerations specific to patients on the female-to-male (FTM) spectrum. Both patients and providers may not accurately assess risk for HPV and other sexually transmitted infections, understand barriers to care, or be aware of recommendations for cervical cancer screening and other appropriate sexual and reproductive health services for this patient population. We review the evidence and provide guidance on minimizing emotional discomfort before, during, and after a pelvic exam, minimizing physical discomfort during the exam, and making adaptations to account for testosterone-induced anatomical changes common among FTM patients.

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