General approach to cancer screening in transgender people

Primary Author(s): 
Madeline B. Deutsch, MD, MPH
Publication Date: 
June 17, 2016

Long term follow up case control studies have not identified differences in cancer rates in trans patients undergoing hormone therapy compared to birth-sex controls, however these studies had many limitations.[1,2] Insufficient evidence exists to determine if transgender people increased or decreased overall as well as organ-specific cancer risk. Primary care providers should conduct an organ based routine cancer screening for all transgender patients in accordance with current guidelines as a component of comprehensive primary care. As a rule, if an individual has a particular body part or organ and otherwise meets criteria for screening based on risk factors or symptoms, screening should proceed regardless of hormone use (Grading: X C S). Therefore, an ongoing and thorough medical and surgical history is crucial to determine an individual patient's screening needs.


  1. Wierckx K, Elaut E, Declercq E, Heylens G, De Cuypere G, Taes Y, et al. Prevalence of cardiovascular disease and cancer during cross-sex hormone therapy in a large cohort of trans persons: a case-control study. Eur J Endocrinol Eur Fed Endocr Soc. 2013 Oct;169(4):471-8.
  2. Wierckx K, Mueller S, Weyers S, Van Caenegem E, Roef G, Heylens G, et al. Long-term evaluation of cross-sex hormone treatment in transsexual persons. J Sex Med. 2012 Oct 1;9(10):2641-51.

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