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Transgender and Gender Diverse Individuals Cancer Risk Study

Background & Purpose

Cancer risk has not been investigated sufficiently in transgender and gender-diverse individuals. It is estimated that 0.6% of US adults are transgender, about 1.4 million individuals in 2014. There are four main risk factors that we think may affect the risk of cancer among transgender people:

  • barriers to healthcare
  • viral infections
  • behavioral factors
  • gender-affirming hormone use

We have initiated a study using the UK Clinical Practice Research Datalink or CPRD—a primary care database that covers 15% of the UK population—to evaluate cancer risk factors, cancer screening uptake, cancer incidence, and mortality. We identified transgender and gender-diverse patients using diagnosis codes and matched them to cisgender people on clinical practice, age, and index date.

See all studies in descriptive epidemiologyinfectious agents, and exogenous hormones.

Study Design

UK Clinical Practice Research Datalink was used to build a cohort of more than 7,000 transgender and gender diverse individuals matched to 280,000 cisgender individuals for comparison. The cohort covers the period 1988–2020.

We extracted important from the electronic medical records data on cancer risk factors (e.g., smoking, viral infections, gender-affirming hormone therapy), cancer screening, cancer incidence, and mortality.  We linked CPRD records to the Hospital and Episodes Statistics and Office of National Statistics to obtain data on hospitalizations and deaths.




Study Team

Sarah Jackson and Meredith Shiels

Sarah Jackson and Meredith Shiels


Sarah S. Jackson, Ph.D., M.P.H., Independent Research Scholar

Meredith Shiels, Ph.D., M.H.S., Senior Investigator


Infections and Immunoepidemiology Branch





Select Publications

Jackson SS et al. Cancer stage, treatment, and survival among transgender patients in the United StatesJ Natl Cancer Inst 2021.  

Jackson SS, et al. Understanding the role of sex hormones in cancer for the transgender community. Trends Cancer 2022.


Research Findings in the News

Transgender Patients and Cancer Disparities 

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