Trans people in England are missing out on vital cancer screening, experts warn | Transgender

Thousands of transgender patients in England are missing out on vital cancer screening because of the way their GP records are written, experts have warned.

All women registered with their GP are automatically invited to breast screening from the age of 50 to 70, and to regular cervical screening from 25 to 64.

But the warnings from experts at the World Cancer Congress in Geneva this week, submitted by official NHS guideshows that many trans patients are not invited to submit to the tests.

In England, trans men who were registered female at birth and who have changed their gender on their patient register to male are not offered breast or cervical screening, regardless of s He had breast reconstruction or a hysterectomy.

Trans women who are still male registered with their GP are not even offered routine breast screening, even if they have been on long-term hormone therapy, which puts them at a disadvantage. increased risk of breast cancer.

Experts say the problem is the way electronic GP records in England are updated when patients change their gender.

NHS England stipulates that when a patient changes their registered gender, they receive a new NHS number and must be registered as a new patient at their GP practice. All their previous medical history is transferred into their new medical record and their previous name, sex at birth, any other gender specific terms and old NHS number are removed.

Because breast and cervical screening programs use patients’ actual gender to generate appointment invitations, many trans patients are missed.

Broader cancer statistics – such as screening uptake, diagnostic stage, treatment adherence and outcomes – are not yet recorded for trans cancer patients.

There are estimated to be between 200,000 and 500,000 trans people in the United Kingdom.

Speaking from the summit in Geneva, Stewart O’Callaghan, chief executive of the charity OutPatients, said: “Even if only 10% change the gender on their GP record, this means tens of thousands cannot not easily access a routine mammogram or smear test that could detect cancer early and save lives.”

NHS guidance says trans patients who are excluded from these national screening programs can request a mammogram or smear from their GP, but GPs are not routinely trained to discuss screening with patients trans or ensure that they have the same access to tests, memories. and following.

Dr. Alison May Berner, an oncologist specializing in cancer care for trans people who was also at the World Cancer Congress, said: “We all have busy lives and count on these vital systems to remember to access screening. In addition, these screenings can be dysphoric for trans people.

“Putting the burden on the individual to approach the GP compounds existing health inequalities for trans patients”.

Gemma Peters, chief executive of Macmillan Cancer Support, said: “Research shows that transgender people are more likely to be exposed to a number of risk factors for cancer, while their access to timely and effective care is affected by a series of complex problems. From screening and diagnosis to treatment and support, it is essential that trans people receive the care they need and are entitled to. The reality is that health inequity puts lives at risk.”

O’Callaghan said more could be done. “The system needs to find a way to track trans status without taking away a person’s right to privacy.

They added: “A potential solution would be to have sex and gender registered at birth on the patient record, but the latter is only accessible at the level of the system or by clinicians with permission. But any solution to this problem must be co-created with trans patients directly”.