Grant: Op. Gr. Adv. 2S_LGBTQI+ Heal. Thr. Res. - Cancer in 2S/LGBTQI+ Indiv and Comm

Transgender and gender-nonbinary (TGNB) people face barriers to preventing cancers caused by the human papillomavirus (HPV), including anal and cervical cancer. Many TGNB individuals report stigma, discrimination, and discomfort in healthcare settings, as well as limited access to providers trained to offer gender-affirming cancer screening. As a result, screening programs that work for the general population often do not meet the needs of TGNB communities. This is especially concerning because evidence suggests that some transgender people have rates of anal cancer and pre-cancer that are as high as other groups known to be at increased risk. Anal cancer is largely preventable through vaccination, regular screening and early treatment, yet many TGNB people are not being reached by existing screening programs. There is an urgent need to develop screening approaches that are inclusive, affirming, and designed in partnership with the communities they aim to serve. The goal of this project is to develop, implement, and evaluate a gender-affirming, community-informed anal cancer screening model for TGNB people that addresses barriers at the patient, provider, and health-system levels. First, we will work with the TGNB community and partners within the healthcare system to better understand barriers and facilitators related to anal cancer screening. Second, we will use the collected data to develop potential models of screening. Third, we will pilot one such model (i.e. self-collected anorectal swabs), which may offer a more comfortable and accessible option for many individuals. By combining community input, healthcare system improvements, and innovative screening options, this project aims to generate practical evidence to improve access to anal cancer prevention for TGNB people. The findings will help inform future programs, policies, and guidelines, and support more equitable cancer prevention across 2S/LGBTQI+ communities.