Vedlegg: transpersoner og kreftrisiko i reproduktive organer

 

 

Her er en grundig systematisk gjennomgang fra 2018 som konkluderer med at det ikke er grunnlag for å si at transpersoner har økt kreftrisiko i reproduktive organer: 

 

“Conclusions: There is insufficient evidence to estimate breast or reproductive cancer prevalence in the transgender population. Gender-affirming hormones have not been shown to affect cancer risk, but there is a clear need for well-designed, robust studies to confirm or refute this (Joint et al., 2018)”
 

Her er enda en gjennomgang av forskning fra 2017 som fant at det ikke finnes grunnlag for å si at transpersoner har en økt kreftrisiko, og at den lille forskjellen mellom cis- og transfolk som var mest tydelig var relatert til økt forekomst av seksuelt overførbare infeksjoner (HIV og HPV) og ikke hormonbruk:

 

“Based on the available evidence, the concerns about cancer in transgender populations, albeit biologically plausible, are neither adequately supported nor convincingly alleviated because of a lack of well-designed epidemiologic studies. [...] 

The limited surveillance data show that the distributions of cancer sites in transgender patients may differ from those in nontransgender patients. These differences are attributable primarily to overrepresentation of malignancies linked to human immunodeficiency virus and HPV infections, most notably Kaposi sarcoma and anal carcinoma (Braun et al., 2017)”

 

En tredje oversiktsartikkel, fra 2019, som ikke fant noen evidens for at hormonell behandling gir en økt risiko for kreft: 

 

“The available data do not show an increased cancer risk in transgender people, and, more importantly, the observed risks do not exceed the risks seen in the general male and female populations (de Blok et al., 2019)”

 

Internasjonale retningslinjer anbefaler ikke fjerning av reproduktive organer eller hyppigere kreftscreening blant transmenn enn hos resten av befolkningen. WPATH skriver i Standars of Care 7 at det ikke finnes evidens for en økt risiko for kreft i reproduktive organer og UCSF retningslinjer er tydelige på det samme, og legger til at myten om økt kreftrisiko kommer fra den feilaktige tanken om at testosteronbruk fører til PCOS - noe vi i dag vet at det ikke gjør:

 


“While there have been several case reports of ovarian cancer among transgender men, there is no evidence to suggest that trans men on testosterone are at increased risk.

 

[...] While historically concerns have existed about increased risk of ovarian cancer in transgender men using testosterone, these concerns were based mostly on the inaccurate premise that testosterone causes a PCOS-like ovary. Furthermore, recent data refutes the increased risk of ovarian cancer in non-transgender women with PCOS (Wesp, 2016)

 

 
Litteraturliste: 

 

Braun, H., Nash, R., Tangpricha, V., Brockman, J., Ward, K., & Goodman, M. (2017). Cancer in Transgender People: Evidence and Methodological Considerations. Epidemiologic Reviews, 39(1), 93–107. https://doi.org/10.1093/epirev/mxw003
 

de Blok, C. J. M., Dreijerink, K. M. A., & den Heijer, M. (2019). Cancer Risk in Transgender People. Endocrinology and Metabolism Clinics of North America, 48(2), 441–452. https://doi.org/10.1016/j.ecl.2019.02.005
 

Joint, R., Chen, Z. E., & Cameron, S. (2018). Breast and reproductive cancers in the transgender population: A systematic review. BJOG: An International Journal of Obstetrics and Gynaecology, 125(12), 1505–1512. https://doi.org/10.1111/1471-0528.15258
 

Wesp, L. (2016). Ovarian and endometrial cancer considerations in transgender men | Transgender Care. UCSF Transgender Care. https://transcare.ucsf.edu/guidelines/ovarian-cancer