Natalie Luehmann1, Mona Ascha2, Emily Chwa3, Paige Hackenberger2, Kareem Termanini2, Christopher Benning4, Danny Sama4, Dylan Felt5,6, Lauren B Beach5,6, Dipti Gupta7, Swati A Kulkarni1, Sumanas W Jordan8. 1. Division of Breast Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 2. Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 3. Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 4. Information Services, Northwestern Memorial HealthCare, Chicago, IL, USA. 5. Feinberg School of Medicine Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA. 6. Northwestern Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA. 7. Division of Breast Imaging, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 8. Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Sumanas.jordan@nm.org.
Abstract
BACKGROUND: Adherence to screening guidelines among transgender and non-binary (TGNB) populations is not well studied. This study examines breast cancer screening patterns among TGNB patients at an urban academic medical center. METHODS: Demographic information, risk factors, and screening mammography were collected. Mammography rates were calculated in populations of interest according to national guidelines, and mammogram person-years were also calculated. Univariate and multivariate logistic regression was performed. RESULTS: Overall, 253 patients were analyzed: 193 transgender women and non-binary people designated male at birth (TGNB DMAB) and 60 transgender men and non-binary people designated female at birth (TGNB DFAB). The median (interquartile range) age was 53.2 years (42.3-62.6). Most patients had no family history of breast cancer (n = 163, 64.4%) and were on hormone therapy (n = 191, 75.5%). Most patients where White (n = 164, 64.8%), employed (n = 113, 44.7%), and had public insurance (n = 128, 50.6%). TGNB DFAB breast screening rates were low, ranging from 2.0 to 50.0%, as were TGNB DMAB screening rates, ranging from 7.1 to 47.6%. The screening rates among the TGNB DFAB and TGNB DMAB groups did not significantly differ from one another. Among TGNB DFAB patients, univariate analyses showed no significant predictors for mammography. Among TGNB DMAB patients, not being on hormone therapy resulted in fewer odds of undergoing mammography. There were no significant findings on multivariate analyses. CONCLUSION: Mammography rates in the TGNB population are lower than institutional and national rates for cisgender patients, which are 77.3% and 66.7-78.4%, respectively. Stage of transition, organs present, hormone therapy, and risk factors should be considered to guide screening.
BACKGROUND: Adherence to screening guidelines among transgender and non-binary (TGNB) populations is not well studied. This study examines breast cancer screening patterns among TGNB patients at an urban academic medical center. METHODS: Demographic information, risk factors, and screening mammography were collected. Mammography rates were calculated in populations of interest according to national guidelines, and mammogram person-years were also calculated. Univariate and multivariate logistic regression was performed. RESULTS: Overall, 253 patients were analyzed: 193 transgender women and non-binary people designated male at birth (TGNB DMAB) and 60 transgender men and non-binary people designated female at birth (TGNB DFAB). The median (interquartile range) age was 53.2 years (42.3-62.6). Most patients had no family history of breast cancer (n = 163, 64.4%) and were on hormone therapy (n = 191, 75.5%). Most patients where White (n = 164, 64.8%), employed (n = 113, 44.7%), and had public insurance (n = 128, 50.6%). TGNB DFAB breast screening rates were low, ranging from 2.0 to 50.0%, as were TGNB DMAB screening rates, ranging from 7.1 to 47.6%. The screening rates among the TGNB DFAB and TGNB DMAB groups did not significantly differ from one another. Among TGNB DFAB patients, univariate analyses showed no significant predictors for mammography. Among TGNB DMAB patients, not being on hormone therapy resulted in fewer odds of undergoing mammography. There were no significant findings on multivariate analyses. CONCLUSION: Mammography rates in the TGNB population are lower than institutional and national rates for cisgender patients, which are 77.3% and 66.7-78.4%, respectively. Stage of transition, organs present, hormone therapy, and risk factors should be considered to guide screening.
Authors: Brittany L Whitlock; Elizabeth S Duda; Molly J Elson; Paul Parker Schwab; Ogul Ersin Uner; Shawn Wen; Jason S Schneider Journal: Endocrinol Metab Clin North Am Date: 2019-03-23 Impact factor: 4.741
Authors: Henk Asscheman; Erik J Giltay; Jos A J Megens; W Pim de Ronde; Michael A A van Trotsenburg; Louis J G Gooren Journal: Eur J Endocrinol Date: 2011-01-25 Impact factor: 6.664