Cancer Screening Recommendations for Transgender/Non-Binary Individuals

Breast/chest, cervical, and colon cancer screening is recommended for some transgender/non-binary individuals.

Below is a summary of the cancer screening guidelines for transgender/non-binary people of average risk. If you feel you are at an increased risk for breast/chest, cervical, or colon cancer, speak with your healthcare provider.

Sexually active refers to:

  • oral, genital, or rectal skin-to-skin contact, or
  • sex with sex toys.

Trans Women/Non-Binary:

AGE 21-69, WITH PAST OR CURRENT SEXUAL CONTACT

  1. who have not had a vaginoplasty/bottom surgery → Cervical cancer screening is not recommended.

  2. who have had a vaginoplasty/bottom surgery without the creation of a neo-cervix → Cervical cancer screening is not recommended. See the Guidelines for Gender-Affirming Primary Care with Trans and Non-Binary Patients (Sherbourne Health) for more information about visual inspection with speculum.

  3. who have had a vaginoplasty/bottom surgery with the creation of a neo-cervix → Recommendation: Routine cervical cancer screening with a Pap test.

AGE 50-69

  1. who have taken gender-affirming hormones for 5 years or more → Recommendation: Routine screening mammograms may be considered at BreastCheck (no referral required) or a diagnostic imaging centre (doctor's referral required)

  2. who have taken gender-affirming hormones for 5 years or more and have breast implants → Recommendation: Routine screening mammograms may be considered but mmust be completed at a diagnostic imaging centre (doctor's referral required)

  3. who have not taken gender-affirming hormones or have taken gender-affirming hormones for less than 5 years → Recommendation: Routine screening mammograms are not recommended

Trans Men/Non-Binary:

AGE 21-69, WITH PAST OR CURRENT SEXUAL CONTACT

  1. who have had their cervix removed and have a history of cervical cancer or high-grade cervical dysplasia → Recommendation: Routine cervical cancer screening with a vault test as per the CervixCheck Guidelines
  2. who have had their cervix removed and do not have a history of cervical cancer or high-grade dysplasia → Cervical cancer screening is not recommended.
  3. who have not had their cervix removed and have had sexual contact → Recommendation: Routine cervical cancer screening with a Pap test

AGE 50-69

  1. who have not had top surgery (still have breast tissue) → Recommendation: Routine screening mammograms are recommended every 2 years at BreastCheck (no referral needed) or a diagnostic centre (doctor's referral required)
  2. who has had top surgery (no longer have breast tissue) → Recommendation: Individualized assessment is required at a diagnostic centre (doctor's referral required)