Breast cancer screening in transgender patients: findings from the 2014 BRFSS survey

Transgender patients undergoing transitions often receive cross-sex hormonal therapies, placing them at uncertain risk for developing breast cancer. There is limited population-based information about the extent to which transgender patients undergo mammography screening. Our purpose was to determine the extent to which transgender patients undergo mammography screening using nationally representative survey data. Transgender participants between ages 40-74 in the 2014 Behavioral Risk Factor Surveillance System survey were included. Proportions undergoing mammography screening in the last year or two years were calculated stratified by age category and transition status [male to female(MtF), female to male(FtM), non-conforming]. For each transition status, predictors of mammography screening were calculated using logistic regression. 220 transgender patients were within 40-74 years old(35% were MtF, 51% were FtM, 14% were non-conforming). 60.0% underwent mammography screening within the last year (MtF-54.5%, FtM-64.3%, non-conforming-58.1%). 74.1% underwent screening within the last two years(MtF-70.1%, FtM-75.9%, non-conforming-77.4%). For all transgender patients, income category (OR 1.16, 0.82-1.64), higher education category (OR 1.09, 0.31-3.86) and health insurance (OR 0.38, 0.10-1.41) were not associated with increased adherence to mammography screening. Transgender patients were comparably likely to undergo mammography screening compared with non-transgender patients (Adjusted OR 0.97, 0.58-1.62). High proportions of transgender survey respondents undergo mammography screening (57.9-66.1% within the last year, 71.9-74.4% within the last two years) in our sample, proportions comparable to non-transgender survey respondents.