Cancer screening is an essential part of our health that many of us might prefer not to think about. However, screening is crucial for everyone, regardless of gender or sexuality, because cancer can affect any body. Regular screening allows for early detection of changes, which can significantly improve your outcomes if you receive a diagnosis. It’s a routine part of looking after your health, not an indication that you’re unhealthy. 

Cervical Screening 

Cervical screening is vital for anyone with a cervix who’s had any kind of sex. The primary purpose is to check for the Human Papillomavirus (HPV), which can cause cervical cancer. Cervical cancer is significant growth of abnormal cells in the cervix. People with a cervix who are 25 or older should undergo cervical screening, regardless of hormonal history or gender identity. If you’ve had a complete hysterectomy (removal of the cervix), consult your doctor to find out if further screening is necessary, as this will depend on your medical history. For those who have undergone genital reconstruction surgery and now have a vagina, it is still possible to test for HPV and monitor any changes in vaginal cells. Even if you’ve had the HPV vaccine, regular cervical screening every five years is still necessary. 

HPV 

HPV is a virus that often shows no symptoms and usually clears up on its own. 99.7% of cervical cancers are caused by certain strains of HPV. Genital HPV is extremely common; most people who have been sexually active will contract HPV at some point, with the majority of infections resolving on their own. There are over 40 different strains of HPV, each with slight variations. The strains of HPV that affect the genitals can be passed on through mouth-genital contact, genital-genital contact, skin-to-skin contact and shared sex toys. Anyone with a cervix is at risk, regardless of gender identity, sexuality, or the type of sex they have. Cervical cancer is most commonly caused by two specific strains, 16 and 18, which are covered by the HPV vaccine and are checked for in every cervical screening test. 

What is a Cervical Screening Test? 

A Cervical Screening Test (CST) is similar to the Pap test you may have heard of before. Cervical screening checks for the presence of HPV and in some cases, looks for cervical cell changes. Cervical cell changes that are left untreated may lead to cervical cancer. During the CST, a healthcare provider inserts a speculum and uses a long thin swab to collect cells from the cervix. The sample is then sent to a pathology lab, and you’ll receive your results afterwards. 

Depending on your age and circumstances, you may have the option to perform a self-collected CST. Self-collected cervical screening does not involve the use of a speculum, and can be done in a private place in your health practitioner's clinic. Self-collected screening can be more comfortable for many people. Discussing these options with a trusted healthcare provider can make the process less intimidating.

Cervical screening is recommended for people who: 

  • are aged 25 to 74 
  • have a cervix, and 
  • have ever had any kind of sexual contact. 

The process of cervical screening can be daunting, especially for those who have faced previous difficulties or feel uncomfortable with the procedure. Here are some tips to make the experience more comfortable: 

  • Self-insert the speculum or request the smallest one available. 
  • Have a support person such as a friend, family member, or partner present during the test. 
  • Choose your preferred position for the test, like sitting up instead of lying down. 
  • Establish a safe word to pause or stop the procedure if needed. 
  • Request a quiet space afterwards to recover if the experience is distressing. 
  • Communicate your needs: whether you prefer detailed explanations, minimal talk, or silence, your preferences should be respected. 

If you’re booking an appointment with a service provider you can let them know if you’d prefer to have a female practitioner or need extra support for a disability. Whilst the screen itself is covered by Medicare, there may be a fee for the consultation that is not completely covered by Medicare. 

For more information on understanding your Cervical Screening Test results and the next steps, visit Cancer Council Australia. 

Breast screening 

Breast screening, commonly referred to as a mammogram, is crucial for anyone with breast tissue to assess the risk of breast cancer. This includes those with breast implants and may include those who have had a mastectomy, lumpectomy, or breast reconstruction surgery. Screening is generally recommended every two years starting at age 50, but your doctor may suggest more frequent or earlier screening (age 40+) based on your personal or family history. 

If you notice symptoms such as a lump, thickening, or discharge from the nipple, it’s important to see a doctor as soon as possible. Screening is not available for people with symptoms. 

Mammograms 

A mammogram is a low-dose X-ray of breast/chest tissue. This X-ray can detect the presence of breast cancers as small as a grain of rice, often before they can be seen or felt. For people living in the ACT, BreastScreen ACT offers free mammogram appointments to all eligible people aged 40 and above.  

Self-Examination 

Self-examinations are another important method for monitoring breast health. While not a replacement for mammograms, they can be done at any age. Here’s how: 

  • Visual check: Look for any noticeable changes, lumps, redness, or swelling. 
  • Check while standing: Raise your arm and use your opposite hand to feel around your breast/chest and armpit. 
  • Check while lying down: Repeat the process with your arm raised, feeling for any abnormalities. 

If you notice anything unusual, don’t hesitate to see your doctor for further examination. Remember, while most lumps are benign, it’s always best to get checked to ensure your health and peace of mind. 

Other Cancers + Reducing Your Risk 

In addition to cervical and breast cancer, it's important to remember that other types of cancer can affect anyone, regardless of gender, sexuality, or body type. Bowel cancer is one example, and regular screening from the age of 50 is crucial for early detection. You can find more information about bowel cancer screening at LGBTQ+ Bowel Cancer Screening & Prevention Info | CAN WE. 

There are also proactive steps you can take to reduce your risk of cancer. These include limiting your alcohol intake, quitting smoking, and making sure you’re protecting yourself properly from the sun. The team at ACON developed Can We, a platform dedicated to providing sexuality and gender-diverse people in NSW, along with their supporters, with valuable resources on cancer prevention. For more information and tips on how to protect your health, visit Can We. 

To understand cancer risks relevant to you and your health, speak to a trusted healthcare provider. If you need support navigating these topics, visit our support page.