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Patients who identify as transgender are less likely to be screened for cancer, suggests a new study from St. Michael's Hospital, which also explores how physicians can handle this disparity.
The study evaluated screening rates for cervical, bad and colorectal cancer in 120 transgender patients eligible for screening, and compared them to screening rates in the cis (non-transgender) group of patients. Family Health Team Academic Hospital.
The odds of bad cancer screening were 70% lower than that of transgender patients, 60% for cervical cancer screening and 50% for colorectal cancer screening – even taking into account other factors such as as the age and number of visits. to the team.
"Our overall cancer screening rates were improving and if we had not thought about looking at this particular patient population, we would be satisfied with our results," said Dr. Tara Kiran, family physician. and researcher at the Center for Urban Health. St. Michael's Solutions.
"This study stems from the finding that our system could miss patients whose gender had changed on their health card but who still needed screening," said Dr. Kiran. "Our results prompted us to develop a system to include transgender patients in our communication activities with patients whose cancer screening was late so we did not miss anything."
Patients who have gone from a woman to a woman and who still need cervical cancer screening are often forgotten when provincial agencies send reminders to those late.
This badysis of cancer screening rates within the family health team led Dr. Kiran and her colleagues to embark on a quality improvement project to learn more about the perspectives of cancer screening. in transgender patients.
"In many cases, doctors had discussed cancer screening with patients and they had made an informed decision not to get tested," she said. "It was really important for us to understand, for people who have gone from female to male, the Pap test can be disturbing because it can sometimes be dysphoric."
The research team is still studying the reasons for lower rates of colorectal cancer screening in transgender patients.
Within the St. Michael's University Family Health Team, physicians, nurse practitioners, social workers and nurses work together to provide comprehensive care to more than 400 transgender patients. The Family Health Team regularly hosts transgender patients who have difficulty finding a primary care provider.
Dr. Kiran and her team are hopeful that this research will help educate primary health care providers about the unique health needs of transgender patients and will help urgent decision-makers to tackle systems that neglect these unique needs.
Clinics at St. Michael's School of Family Health have recently taken steps to make waiting rooms more gender-friendly, for example by displaying Positive Space posters and ensuring room access. neutral baths. They also provided training to frontline office staff involved in the registration of patients on the provision of sensitive and non-badist care.
"This study shows the importance of a fairness approach," said Dr. Kiran. "Improvements in care may not reach everyone and we need targeted strategies to reach those with unique needs.Our research also highlights the importance of knowing not only whether patients have undergone a test, but also if they had an enlightened discussion.
"Improving shared decision-making may be a more appropriate quality improvement goal than increasing cancer screening rates. We hope that the involvement of trans patients in our quality improvement efforts will help us challenge our badumptions and provide better care to the trans people. "
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