Observational studyJournal of general internal medicine2014
Female-to-male patients have high prevalence of unsatisfactory Paps compared to non-transgender females: implications for cervical cancer screening.
Observational study in Journal of general internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
72 citing papers in PubMed, 3 syntheses or guidelines pooled it, 222 citations in OpenAlex.
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- The worldwide burden of HIV in transgender individuals: An updated systematic review and meta-analysis.PloS one · 2021Pooled it
- Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People.Journal of acquired immune deficiency syndromes (1999) · 2016Pooled it
- Trial
- Comparing self- and provider-collected swabbing for HPV DNA testing in female-to-male transgender adult patients: a mixed-methods biobehavioral study protocol.BMC infectious diseases · 2017Trial
- Development of a Culturally Sensitive Intervention for Cervical Cancer Screening Promotion for Latinx Transgender Individuals.Cancer medicine · 2026Article
- In-Depth Assessment of Cytologic Features in 106 Cervical Papanicolaou Tests of Transgender Male Patients on Testosterone: An Institutional Experience.Diagnostic cytopathology · 2025Article
- Mapping the Conceptual Terrain Avoiding Common Conflations: Tentative Guide to Fruitful Discussion about Sexes and Genders.Archives of sexual behavior · 2025Article
- A Scoping Review Mapping Trans* and Gender Diverse People's Representation in Cancer Research.Cancer medicine · 2025Article
- Clinical practice guidelines: sexual dysfunction in gynecological cancer patients.Sexual medicine · 2025Review
- Early detection of cervical and breast cancer in transgender and allogender individuals assigned female at birth: A scoping review.International journal of transgender health · 2025Review
- Strategies to Optimize Cervical Cancer Screening Rates Among Transgender and Gender-Diverse People Assigned Female at Birth.Journal of general internal medicine · 2024Article
- Observational
- The vaginal microbiome of transgender men receiving gender-affirming hormonal therapy in comparison to that of cisgender women.Scientific reports · 2024Article
- Translation and Psychometric Evaluation of the Greek Version of the Attitudes toward Transgendered Individuals Scale.Behavioral sciences (Basel, Switzerland) · 2024Article
- Article
- Cervical cancer in a transgender man: lessons learnt to improve care.BMJ case reports · 2024Article
- Vaginal Cuff Dehiscence in Transgender Patients After Minimally Invasive Hysterectomy.Journal of minimally invasive gynecology · 2024Article
- Prevalence and predictors of cancer screening in transgender and gender nonbinary individuals.International journal of transgender health · 2024Article
- Breast and cervical cancer in transgender men: literature review and a case report.Therapeutic advances in medical oncology · 2024Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about whether and how screening for cancers of natal reproductive structures, including cervical cancer, in female-to-male (FTM) transgender individuals differs from cancer screening among non-transgender females.
objectiveTo investigate anecdotal reports from clinicians of high rates of inadequate Papanicolaou (Pap) tests among transgender men.
designResults of Pap tests performed on 233 FTM and 3,625 female patients at an urban community health center between 2006 and 2012 were extracted from an electronic medical record. KEY
resultsCompared to female patients, FTM patients were more likely to have an inadequate Pap, with prevalence of inadequate samples 8.3 times higher among tests of FTM patients (10.8% vs. 1.3% of tests). FTM patients had over ten times higher odds of having an inadequate Pap after adjusting for age, race, and body mass index (AOR = 10.77, 95% CI = 6.83, 16.83). When years on testosterone therapy was added to the model, the relationship between transgender identity and Pap inadequacy was attenuated, but remained strongly associated (AOR = 6.01, 95% CI = 3.00, 11.50), and time on testosterone was also associated (AOR = 1.19, 95% CI 1.04, 1.36). FTM patients were more likely than females to have had multiple inadequate tests, and had longer latency to follow-up testing.
conclusionsThe high unsatisfactory sample prevalence among FTM patients is likely due to a combination of physical changes induced by testosterone therapy and provider/patient discomfort with the exam. Clinicians should receive training in increasing comfort for FTM patients during the exam. FTM patients should be alerted that high rates of inadequate screening may require follow-up testing. Alternatives to repeated Pap testing, such as cytologic reprocessing of inadequate samples or primary human papillomavirus (HPV) DNA screening, should be studied for efficacy and acceptability among FTM patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.