Understanding Sexual and Gender Minority Populations and Organ-Based Screening Recommendations for Human Papillomavirus–Related Cancers

Sep 24, 2026

Sexual and gender minority (SGM) populations face barriers to health care and are at heightened risk for human papillomavirus (HPV)–related cancers of the anogenital tract and oropharynx. The document clarifies inclusive language for SGM care and presents screening and prevention recommendations based on expert narrative review of the literature through February 2023. It advocates sexual orientation and gender identity data collection and an organ-based screening approach, supports cervical screening per national guidance, recommends risk-based screening for additional HPV-related cancers, and encourages HPV vaccination for at-risk individuals up to age 45.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Objectives

Materials and Methods

Results

Conclusions

Background: HPV and SGM-Related Barriers

Terminology and Inclusive Language

Understanding Sexual and Gender Minority Populationsand Organ-Based Screening Recommendations for Human Papillomavirus–Related Cancers Dominique Jodry, MD,1 Juno Obedin-Maliver, MD, MPH, MAS,2 Lisa Flowers, MD, MPH,3 Naomi Jay, PhD, NP,4 Serina Floyd, MD,5 Deanna Teoh, MD,6 Christine Conageski, MD, MSc,1 Levi Downs, MD, 7 and Michelle J. Khan, MD, MPH2 Objectives: Sexual gender minority (SGM) populations are at risk for human papillomavirus (HPV)–related cancers ofthe anogenital tract and oropharynx and often face barriers to health care. The goals of this document are to clarify language to provide inclusive care for SGM populations and to provide recommendations for screening and prevention of HPV-related cancers in SGM populations. Materials and Methods: An expert committee convenedby the American Society for Colposcopy and Cervical Pathology performed a narrative review of the literature through February2023. A comprehensive MEDLINE database search was performed for relevant studies. The literature review was divided into categories by organ/topic and by SGM population. Given the variability in available data for several of the categories, recommendations were made based on national guidelines where appropriate or expert opinion where there were less data to support risk-based guidelines. Results: Definitions and terminology relevant to SGM populations arepresented. The authors advocate the adoption of sexual orientation gender identity data collection and an organ-based screening approach, which is possible with knowledge of patient anatomy, sexual behaviors, and clinical history. This includes screening for cervical cancer per national recommendations, as well as screening for anal, vulvar, vaginal, penile, and oral cancers based on risk factors and shared clinical decision making. The authors recommend consideration of HPV vaccination in all SGM individuals up to age 45 years old who are at risk. Conclusions: An organ-based screening approach is part ofa global strategy to create an inclusive care environment and mitigate barriers to screening and prevention of HPV-mediated cancers in SGM populations. Key Words: HPV, sexual gender minority, human papillomavirus, neoplasia (J Low Genit Tract Dis 2023;27: 307–321) H uman papillomavirus (HPV) is responsible for cancers ofthe anogenital tract (cervix, anus, vulva, vagina, and penis) and cancers ofthe oropharynx. Sexual and/or gender minority (SGM) populations face barriers to health care and as a result experience disparate outcomes in cancer prevention. The goals of this docu- 1University ofColorado, Aurora, CO; 2Stanford University School ofMedicine, Stanford, California; 3Emory University School of Medicine, Atlanta, GA; 4University of California, San Francisco School of Medicine, San Francisco, California; 5Planned Parenthood of Metropolitan Washington, DC, Washington, DC; 6Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; and 7Park Nicollet Health Services, Minneapolis, MN Reprint requests to: Michelle J. Khan, MD, MPH, Department of Obstetrics and Gynecology, Stanford University School of Medicine, 453 Quarry Road, Mail Code 5317, Palo Alto, CA 94304. E-mail: [drkhan@stanford.edu](drkhan@stanford.edu)[ ](drkhan@stanford.edu)The authors have declared they have no conflicts of interest. IRB status: Exempt. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/LGT.0000000000000763 ment are to define SGM populations, to review the literature on HPV-related disease in SGM populations, and to provide recommendations for screening and pre

FAQs

What is the main purpose of the document for SGM populations?

To clarify inclusive language for sexual and gender minority care and to provide recommendations for screening and prevention of HPV-related cancers in SGM populations.

What approach do the authors advocate for screening?

An organ-based screening approach supported by knowledge of patient anatomy, sexual behaviors, and clinical history, combined with collection of sexual orientation and gender identity data.

Which HPV-related cancers are addressed in the screening recommendations?

Cervical cancer is recommended per national guidance, and screening for anal, vulvar, vaginal, penile, and oral cancers is recommended based on risk factors and shared clinical decision-making.

Sep 24, 2026

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