Characteristic findings of cervical Papanicolaou tests from transgender patients on androgen therapy: Challenges in detecting dysplasia

Cytopathology : Official Journal of the British Society for Clinical Cytology
B D AdkinsV L Weiss

Abstract

The characteristic features of Papanicolaou (Pap) tests collected from female-to-male (FTM) transgender patients on androgen therapy have not been well defined in the literature. FTM transgender patients require cervical cancer screening with the same recommended frequency as cis-gender females. Dysplasia remains challenging to differentiate from atrophy. Without pertinent history, the atrophic findings in younger transgender patients can be misinterpreted as high-grade dysplasia. A review of all cervical Pap tests of transgender patients receiving androgen therapy (2010-2017) was performed. Bethesda diagnosis, cytomorphological features, HPV testing and cervical biopsy results were reviewed. Eleven transgender patients receiving androgen therapy were identified with 23 cervical Pap tests, 11 HPV tests and five cervical biopsies performed. A review of the Pap tests demonstrated: 57% negative for intraepithelial lesion; 13% unsatisfactory; 13% atypical squamous cells of undetermined significance; 13% atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion; and 4% high-grade squamous intraepithelial lesion. The rates of abnormal tests were higher than our age-matched cis-gender atrophic cohort rates of...Continue Reading

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Citations

Sep 14, 2018·Current Oncology Reports·Elizabeth J Cathcart-Rake
Sep 16, 2020·BJOG : an International Journal of Obstetrics and Gynaecology·S WeyersM Arbyn
Feb 7, 2021·Journal of General Internal Medicine·Sean J IwamotoMicol S Rothman
Sep 26, 2020·Cancer Nursing·Lucille KerrTiffany Jones

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