Human papillomavirus (HPV) self-sampling to encourage the uptake of cervical screening

Shiraz, Aslam; Schiemer, Roberta; Staley, Helen; Matsushita, Tomomi; Hasegawa, Takeshi; Bryant, Andrew; Inoue, Eisuke; Egawa, Nagayasu; Gajjar, Ketankumar B

doi:10.1002/14651858.cd014502

Cited by 2 publications

(1 citation statement)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Levels of discomfort and invasiveness could contribute to this distribution of results. Cervical screening uptake rates in CG women remain low worldwide, likely due to difficulties tolerating examination [53]. This effect is compounded by multiple factors in TGD people.…”

Section: Discussionmentioning

confidence: 99%

Cancer screening attendance rates in transgender and gender-diverse patients: a systematic review and meta-analysis

Chan,

Jamieson,

Draper

et al. 2024

Preprint

View full text Add to dashboard Cite

Objectives: To examine disparities between transgender and gender-diverse (TGD) and cisgender (CG) people through analysis of attendance rates for cancer screening and compare differences between types of cancer screened. Design: Systematic review and meta-analysis. Data sources: PubMed, EMBASE [via Ovid], CINAHL Complete [via EBSCO], and Cochrane Library from inception to 30 September 2023. Methods: Studies for inclusion were case-control or cross-sectional studies with quantitative data investigating TGD adults attending any cancer screening services. Exclusion criteria were studies with participants ineligible for cancer screening or without samples from TGD individuals, qualitative data, and cancer diagnosis from symptomatic presentation or incidental findings. A modified Newcastle-Ottawa Scale was used to assess risk of bias and reports rated poor were excluded. Results were synthesised through random-effects meta-analysis and narrative synthesis. Results: Searches identified 25 eligible records, whereby 18 met risk of bias requirements. These were cross-sectional studies, including retrospective chart reviews and survey analyses, and encompassed over 14.8 million participants. The main outcomes measured were up-to-date (UTD) and lifetime (LT) attendance. Meta-analysis found differences for UTD cervical (OR=0.37, 95% CI [0.23, 0.60], p<0.0001) and mammography screening (OR=0.41, 95% CI [0.20, 0.87], p=0.02). There were no meaningful differences seen in LT results. Pooling total odds ratios for each synthesis (cervical, breast, prostate, and colorectal cancer) showed reduced attendance in TGD participants (OR=0.50, 95% CI [0.37, 0.68], p<0.0001). Narrative synthesis of seven remaining articles supported meta-analysis results, finding generally reduced screening rates in TGD versus CG participants. Conclusions: TGD individuals are overall less likely to utilise cancer screening compared to CG counterparts. The greatest disparity in attendance was seen specifically in UTD cervical screening. Limitations of this review included high risk of bias within studies, high heterogeneity, and a lack of resources for further statistical testing. Individual and structural factors such as psychological distress, socioeconomic status, and healthcare accessibility can prevent TGD people from accessing cancer screening. Bridging this gap will require consolidated efforts from healthcare systems including reviews of structural design, innovation of accessible and inclusive technology, education of HCPs, and reassessment of patient information resources. Joint production of future interventions with the TGD community is vital to improving both cancer screening experience and outcomes. Funding: This work was supported by the INSPIRE grant generously awarded to the Hull York Medical School by the Academy of Medical Sciences through the Wellcome Trust [Ref: IR5\1018]. Systematic review registration: PROSPERO CRD42022368911.

show abstract

Section: Discussionmentioning

confidence: 99%

Cancer screening attendance rates in transgender and gender-diverse patients: a systematic review and meta-analysis

Chan,

Jamieson,

Draper

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Cancer screening attendance rates in transgender and gender-diverse patients: a systematic review and meta-analysis

Chan,

Jamieson,

Draper

et al. 2024

BMJ EBM

View full text Add to dashboard Cite

ObjectivesTo examine disparities in attendance rates at cancer screening services between transgender and gender-diverse (TGD) people in comparison with their cisgender (CG) counterparts, and to determine whether these differences were based on the anatomical organ screened.DesignSystematic review and meta-analysis.Data sourcesPubMed, EMBASE (via Ovid), CINAHL Complete (via EBSCO) and Cochrane Library from inception to 30 September 2023.MethodsStudies for inclusion were case-control or cross-sectional studies with quantitative data that investigated TGD adults attending any cancer screening service. Exclusion criteria were studies with participants who were ineligible for cancer screening or without samples from TGD individuals, qualitative data and a cancer diagnosis from symptomatic presentation or incidental findings. A modified Newcastle-Ottawa Scale was used to assess risk of bias, during which seven reports were found incompatible with the inclusion criteria and excluded. Results were synthesised through random-effects meta-analysis and narrative synthesis.ResultsWe identified 25 eligible records, of which 18 were included in the analysis. These were cross-sectional studies, including retrospective chart reviews and survey analyses, and encompassed over 14.8 million participants. The main outcomes measured were up-to-date (UTD) and lifetime (LT) attendance. Meta-analysis found differences for UTD cervical (OR 0.37, 95% CI 0.23 to 0.60, p<0.0001) and mammography (OR 0.41, 95% CI 0.20 to 0.87, p=0.02) but not for prostate or colorectal screening. There were no meaningful differences seen in LT attendance based on quantitative synthesis. Narrative synthesis of the seven remaining articles mostly supported the meta-analysis. Reduced rates of screening engagement in TGD participants were found for UTD cervical and mammography screening, alongside LT mammography screening.ConclusionsCompared with their CG counterparts, TGD individuals had lower rates of using cervical and mammography screening at the recommended frequencies but displayed similar prevalences of LT attendance. The greatest disparity was seen in UTD cervical screening. Limitations of this review included high risk of bias within studies, high heterogeneity and a lack of resources for further statistical testing. Bridging gaps in healthcare to improve cancer screening experiences and outcomes will require consolidated efforts including working with the TGD community.PROSPERO registration numberCRD42022368911.

show abstract

Human papillomavirus (HPV) self-sampling to encourage the uptake of cervical screening

Cited by 2 publications

References 65 publications

Cancer screening attendance rates in transgender and gender-diverse patients: a systematic review and meta-analysis

Cancer screening attendance rates in transgender and gender-diverse patients: a systematic review and meta-analysis

Cancer screening attendance rates in transgender and gender-diverse patients: a systematic review and meta-analysis

Contact Info

Product

Resources

About