In partnership with OUTpatients and Macmillan Cancer Support

Cancer screening for transgender (trans) and non-binary people

Cancer screening uses tests to help find cancer early, or to find people who may need treatment to stop cancer developing.

It is important to know what types of screening are right for your body. The NHS offers routine screening for breast, cervical and bowel cancer. In some areas, there is also screening for lung cancer.

Invitations are usually based on your age and the gender that is registered with your GP. This may not always match the screening you need, especially if your gender identity or medical history is different from the details on your NHS record.

If you are unsure or have questions about cancer screening, your GP or another person in your healthcare team can help.

Related pages

Breast cancer screening

Breast screening is for people with breasts. That might include you if:

you were assigned female at birth and have breasts
you were assigned male at birth and have developed breasts from feminising hormone therapy.

Screening is automatically offered to anyone who is registered as female with their GP and aged between 50 and 70.

If you are registered as male with your GP and have breasts, you can ask them to arrange screening for you.

If you have had chest reconstruction (top surgery)

If you have had surgery to remove breast tissue or change the shape of your chest (top surgery), you might not need or be able to have the usual screening test. This test is called a mammogram.

You may still have some breast tissue on your chest and you still need to check for changes regularly. If you have a high-risk of breast cancer because it runs in your family, you may be offered regular screening using an MRI scan.

There are useful organisations that have more information about this:

CoppaFeel – How to check your breast, pecs or chest.
OUTpatients – Best for my chest - breast cancer screening information.

Klinefelter syndrome

If you have Klinefelter syndrome, you are not included in the routine NHS screening programme. But you do have a higher breast cancer risk.

Check your chest regularly and speak to your GP if you notice any changes. They can arrange tests if needed. We have more information about variations in sex characteristics and cancer.

Related pages

Breast cancer

Cervical screening

You should consider going for cervical screening if you were born with a cervix and still have it. The cervix is the lower part of the womb (uterus) that joins to the top of the vagina.

Cervical screening is important for anyone with a cervix who has ever:

been sexually active, whatever their sexual orientation
put anything inside their vagina, including fingers and tampons.

Cervical screening is automatically offered to anyone who is registered as female with their GP and aged between 25 and 64.

If you are registered as male with your GP and have a cervix, you can arrange cervical screening in the following ways:

If you live in England and Wales

Talk to your GP. If you want ongoing screening appointments and reminders, ask them about opting-in for this. If you have arranged a screening appointment, you can also ask about opting-in at your appointment.
If you live in Scotland

You will be automatically invited if you have not changed your CHI number, or if you changed it after 14th June 2015. Talk to your GP if you changed your CHI number before this.
If you live in Northern Ireland

Talk to your GP for more information about arranging the screening you need.

In the video below from My Cervix My Service from CliniQ you can find out what to expect during a cervical screening at this trans specific clinic. This can help you prepare for your appointment and answer practical questions you might have about screening as experiences will vary in standard NHS clinics.

Opting out of cervical screening invitations

If you do not have a cervix and are registered as female with your GP, your GP can make a request on the screening system to stop sending you screening invitations. You can find out more in OUTpatients ‘Remove the doubt - cervical screening’ information.

Related pages

Cervical cancer

Bowel cancer screening

Bowel screening is offered to everyone registered with a GP. You will be sent a home screening test for bowel cancer in the post.

You will get the first one when you are aged between 50 and 60. The exact age depends on where you live in the UK.

The screening programmes are based on research in each country and reflect the different needs of the populations.

Related pages

Bowel cancer

Lung cancer screening

Lung cancer screening is not yet available in all areas of the UK. In some areas of England, you will be sent an invitation for screening if you are registered with a GP, and you:

are between 55 and 74 years of age
smoke or used to smoke.

The NHS has more information about lung cancer screening in England.

Related pages

Lung cancer

Do gender-affirming treatments cause cancer?

There is not a lot of research about gender-affirming treatments and cancer risk. Some treatments may slightly increase or lower your risk of developing some types of cancer.

If you see a gender identity specialist, they can help explain what this means in your situation. For example, they may talk to you about any symptoms you should look out for or what screening you should have.

OUTpatients also offer a booklet that helps explain cancer risk for transgender (trans) and non-binary people. Visit outpatients.org.uk/tnbgd-screening to download the booklet.

Feminising hormone therapy and breast cancer risk

Feminising hormones increase the risk of breast cancer. If you were assigned male at birth and take feminising hormone therapy, your risk may be higher than a cisgender man. But your risk is still lower than a cisgender woman.

Cisgender means a person’s gender identity matches the sex they were assigned at birth. There is more information about breast cancer screening above.

Feminising hormone therapy and prostate cancer risk

Feminising hormones lower the risk of prostate cancer. If you were assigned male at birth and take feminising hormone therapy, your risk may be lower than a cisgender man. But it is important to remember that you do still have a prostate, and prostate cancer can develop in this area.

There is no screening program for prostate cancer. A blood test called the PSA test can be used with other tests to help diagnose prostate cancer. But it is not routinely used to screen for prostate cancer.

You can ask your GP for a PSA blood test if you are aged over 50 or if you have one of these risk factors:

you are Black
other family members have had prostate cancer
you have a BRCA2 gene change.

There are benefits and disadvantages to having a PSA test. Your GP will talk to you about these before you have a test.

Tell your GP if you have problems passing urine (peeing). This includes:

needing to pee suddenly
pain when you pee
blood in your pee.

Prostate Cancer UK also have information about prostate cancer for trans women.

Masculinising hormone therapy and cancer risk

There is not a lot of information about cancer risks and masculinising hormone therapy. It is possible that gender-affirming testosterone may increase the risk of womb cancer. But current evidence has not shown this in trans men.

More research is needed into the long-term effects of gender-affirming hormone therapy.

It is still important to be aware of possible signs or symptoms of cancer. This includes the following symptoms:

Pelvic symptoms – if you have a vagina, cervix, womb or ovaries, you should tell your GP if you often have a bloated or swollen tummy, or if it does not go away. Also tell your GP if you have unexpected or heavy vaginal bleeding. We have more detailed information about symptoms of cervical, ovarian and womb cancer.
Chest symptoms – tell your GP if you notice lumps or any changes to your chest, nipples or armpits. You can use the CoppaFeel guide to help you learn how to check.
You can find out more about breast and cervical screening above.

Chest reconstruction (top surgery) and cancer risk

Top surgery does not usually remove all the breast tissue. This means there is still a risk of breast cancer. But this risk is less than before your surgery.

It is important to know how your chest normally looks and feels. This means you can recognise any changes. CoppaFeel’s guide explains how to check. Tell your GP if you notice lumps or any changes to your chest, nipples or armpits.

There is more information about breast cancer screening above.

Vaginoplasty and vulvoplasty

If you have had surgery to make a vagina or vulva, the risks of cancer in these areas are thought to be low. You do not have a cervix and do not need to go for cervical screening. Cervical screening is also called a smear test.

But it is important to remember that you do still have a prostate. This means prostate cancer can develop in this area. There is no screening programme for prostate cancer. Tell your GP if you have problems passing urine (peeing). This includes:

needing to pee suddenly
pain when you pee
blood in your pee.

Prostate Cancer UK have information about prostate cancer for trans women.

Phalloplasty and metoidioplasty

Depending on the surgery you have had, you may still have a vagina, cervix, womb or ovaries. If you are not sure, your medical notes should explain your surgery. Your GP can also help, or they can help you contact your surgeon if needed.

You should tell your GP if you often have a bloated or swollen tummy, or if it does not go away. Also tell your GP if you have unexpected or heavy vaginal bleeding.

We have more detailed information about symptoms of cervical, ovarian and womb cancer.

You can find out more about cervical screening above.

How can I reduce my cancer risk?

Everyone’s risk of cancer is affected by many different factors. Sometimes understanding your risk factors can help you make decisions about how to manage or reduce your cancer risk.

But it is also important to remember that some factors are outside your control, or may be difficult to change without support.

Things that affect cancer risk include:

Lifestyle – for example, your risk is higher if you smoke or drink alcohol, and may be higher depending on your diet, sexual practices or physical activity levels.
Genetic conditions or a family history of cancer – some people have a higher risk of developing certain types of cancer, such as breast or prostate cancer, because of their genes or family history.

If you are worried about cancer risk, talking to your GP or healthcare team can help. They can offer advice and, if needed, arrange tests or ongoing care to help manage your risk. They can support with changes such as:

stopping smoking
keeping to a healthy weight
eating and drinking healthily
being physically active.

The World Cancer Research Fund has more information about making lifestyle changes to reduce your cancer risk.

Symptoms of cancer

Different types of cancer have different symptoms. Many symptoms can be caused by things other than cancer. It is important to understand your body and be aware of any changes.

There may be parts of your body you are less comfortable with or feel upset about. Thinking about any symptoms in these areas may be very difficult. Try not to let this stop you from getting checked if you have any changes or symptoms. This includes the following:

Ongoing symptoms – this means a symptom that lasts for more than 3 weeks. This could be a cough that does not go away, a change in bowel function, a mouth ulcer that does not heal, or feeling bloated most days.
Unexplained symptoms – this means a symptom that does not have an obvious cause. For example, you may have a lump or bleeding without any injury.
Unusual symptoms – this means a change in your body that is not normal for you. It could be a change in a cough that you have had for a long time, a change to a mole or an unexplained change to the look or feel of your chest or breasts.

We have more information about what to look for and when to get a symptom checked.

You can contact your GP for advice about symptoms. You may find our tips for talking to your GP or practice nurse helpful. A trans and non-binary friendly sexual health and wellbeing service may also be able to help. You can check if this is available in your area on Tranzwiki.

If you need cancer treatment

If you have been diagnosed with cancer, you may have questions about how treatment could affect your body, gender identity or gender-affirming care.

Our cancer treatment and gender-affirming care page has information about:

making treatment decisions
how your treatment is planned
getting specialist support.

Get this information in another language or format

We are committed to making our website as accessible as possible, to make sure that everyone can use it.

We have information about cancer for LGBTQIA+ people in over 16 languages. You can also listen to our audiobook LGBTQIA+ people and cancer for free.

If we do not have what you are looking for, you can ask for information to be translated for free or provided in a format to suit you. Email us at informationproductionteam@macmillan.org.uk or call us on 0808 808 0000.

About our information

This information was developed in partnership with OUTpatients. OUTpatients is a cancer support and advocacy charity for the LGBTIQ+ community. It provides a safe space for anybody who identifies as part of the queer community and has had an experience with any type of cancer. This is for any stage of cancer, from testing, diagnosis, treatment and remission through to long-term care.

LGBTQIA+ is an acronym for lesbian, gay, bisexual, transgender, queer, intersex and asexual people. The plus sign (+) represents any other romantic or sexual attraction other than heterosexual, and any gender identity other than cis.

Macmillan is working to improve how our cancer information works for LGBTQIA+ people. There are areas of our information that we are still working on to make more inclusive.

When we write or update our information, we think about the needs of all different audiences. This includes people of all sexual orientations and gender identities. We are careful about the language and wording we use. We include information about specific LGBTQIA+ issues when needed. We offer other useful sources of information and support when this is helpful.

We welcome feedback on any of our information. If you have feedback, please contact us at informationproductionteam@macmillan.org.uk

References

Below is a sample of the sources used in our information for people who are LGBTQIA+. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk

Adley M, O'Donnell A, Scott S. How LGBTQ + adults' experiences of multiple disadvantage impact upon their health and social care service pathways in the UK & Ireland: a scoping review. BMC Health Services Research [Internet]. 2025; 25 (1): 244. Available from: doi.org/10.1186/s12913-025-12232-8 (accessed October 2025).

Berner AM, Atkinson SE. The implications of hormone treatment for cancer risk, screening and treatment in transgender individuals. Best Practice and Research Clinical Endocrinology and Metabolism [Internet]. 2024; 38 (5):101909. Available from doi.org/10.1016/j.beem.2024.101909 (accessed October 2025).

Braybrook D, Rosa WE, Norman C, Harding R, Bristowe K. The inclusion of LGBTQ + people within UK health policy: a critical discourse analysis. International Journal for Equity in Health [Internet]. 2025; 24 (1):88. Available from doi.org/10.1186/s12939-025-02446-x (accessed October 2025).

D'Elia M, Nabhani-Gebara S, O'Callaghan S. Safe and supportive prescribing in transgender and non-binary patients with cancer. British Journal of Clinical Pharmacology [Internet]. 2024; 90(10): 2401-2408. Available from doi.org/10.1111/bcp.16235 (accessed October 2025).

Giblin, J., Coad, B., Lamb, C. et al. UK recommendations for the management of transgender and gender-diverse patients with inherited cancer risks. BJC Reports [Internet]. 2023; 1:1. Available from doi.org/10.1038/s44276-023-00002-0 (accessed October 2025).

Kneale D, Henley J, Thomas J, French R. Inequalities in older LGBT people's health and care needs in the United Kingdom: a systematic scoping review. Ageing and Society [Internet]. 2021; 41(3):493-515. Available from doi.org/10.1017/S0144686X19001326 (accessed October 2025).

Monro, S., Wall, S. S., & Wood, K. (2023). Intersex equality, diversity and inclusion and social policy: Silences, absences, and erasures in Ireland and the UK. Critical Social Policy [Internet]. 2024; 44(1): 3-22. doi.org/10.1177/02610183231175055 (accessed October 2025).

Zeeman L, Aranda K. A systematic review of the health and healthcare inequalities for people with intersex variance. International Journal of Environmental Research and Public Health [Internet]. 2020;17 (18):6533. doi.org/10.3390/ijerph17186533 (accessed October 2025).