Understanding Sexual and Gender Minority Populations and Organ-Based Screening Recommendations for Human Papillomavirus–Related Cancers

• Type of Material: Article
• Authors: Dominique Jodry, University of Colorado; Juno Obedin-Maliver, Stanford University; Lisa Flowers, Emory University; Naomi Jay, University of California, San Francisco, San Francisco, California; Serina Floyd, Planned Parenthood of Metropolitan Washington, District of Columbia; Deanna Teoh, University of Minnesota, Minneapolis, Minnesota; Christine Conageski, University of Colorado; Levi Downs, Park Nicollet Health Service; Michelle J Khan, Stanford University
• Language: English
• Date: 2023-09-20
• Publisher: Wolters Kluwer Health, Inc
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1097/LGT.0000000000000763
• Title of Journal or Parent Work: Journal of Lower Genital Tract Disease
• Volume: 27
• Issue: 4
• Start Page: 307
• End Page: 321
• Keywords: HPV; sexual gender minority; human papillomavirus; anogenital tract; neoplasia
• Research Categories: Gender Studies; Health Sciences, Medicine and Surgery; Health Sciences, Oncology

Abstract

Objectives Sexual gender minority (SGM) populations are at risk for human papillomavirus (HPV)–related cancers of the anogenital tract and oropharynx and often face barriers to health care. The goals of this document are to clarify language to provide inclusive care for SGM populations and to provide recommendations for screening and prevention of HPV-related cancers in SGM populations. Materials and Methods An expert committee convened by the American Society for Colposcopy and Cervical Pathology performed a narrative review of the literature through February 2023. A comprehensive MEDLINE database search was performed for relevant studies. The literature review was divided into categories by organ/topic and by SGM population. Given the variability in available data for several of the categories, recommendations were made based on national guidelines where appropriate or expert opinion where there were less data to support risk-based guidelines. Results Definitions and terminology relevant to SGM populations are presented. The authors advocate the adoption of sexual orientation gender identity data collection and an organ-based screening approach, which is possible with knowledge of patient anatomy, sexual behaviors, and clinical history. This includes screening for cervical cancer per national recommendations, as well as screening for anal, vulvar, vaginal, penile, and oral cancers based on risk factors and shared clinical decision making. The authors recommend consideration of HPV vaccination in all SGM individuals up to age 45 years old who are at risk. Conclusions An organ-based screening approach is part of a global strategy to create an inclusive care environment and mitigate barriers to screening and prevention of HPV-mediated cancers in SGM populations.