Rastreamento de câncer de colo uterino em homens transgêneros em Sergipe: do perfil epidemiológico nacional às barreiras locais

Abstract

Cervical cancer (CCU) is the fourth most common type of cancer among the population with a cervix. Early detection of this neoplasm is achieved through screening via cytopathological examination. In this context, this study aimed to investigate cervical cancer screening in transgender men, focusing on the national epidemiological profile and local barriers in Sergipe. This is a multi-method study: 1) Ecological study conducted using the DATASUS – Tabnet and DOU systems, considering the three-year period 2022-2024; 2) Cross-sectional observational study with a quantitative approach through the application of a questionnaire containing 23 questions; 3) Qualitative study through interviews that were analyzed based on Bardin's content analysis. Phases 2 and 3 were submitted to the Research Ethics Committee (CEP/UFS) and, after approval, were carried out with transgender men attending the Comprehensive Health Clinic for Transgender People at the Federal University of Sergipe, in the municipality of Lagarto, during the period from March to July 2025, after signing the Informed Consent Form. The results of phase 1 of the study identified that in the three-year period 2022-2024, 24,868 transgender men underwent cervical cancer screening in Brazil, with the state of Bahia standing out, concentrating approximately 12% (2,925) of the total number of transgender men who underwent screening. Furthermore, it is important to highlight that 22 services accredited by the Ministry of Health for the Transgender Process within the SUS (Brazilian Public Health System) were identified, distributed across 14 Federative Units, reinforcing the limited availability of the service and the lack of actions aimed at promoting and preventing diseases. The results of stage 2 characterize the 44 research participants, showing an average age of 26.45 years and a percentage of the sample population that underwent screening, corresponding to 36.4%. This result demonstrates that although 95.45% of trans men are aware of the risk of developing cervical cancer, there is still low adherence to screening, which can be explained by the barriers faced in seeking health services. Finally, among the barriers most cited by research participants regarding seeking cervical cancer screening are: lack of technical preparation, sensitivity of professionals, embarrassment, and transphobia. The results of this study show that, despite knowledge about the risks related to cervical cancer in trans men, adherence to screening remains limited, with the highest number of examinations being related to trans men aged 30 or older. Furthermore, the existence of specialized institutions does not guarantee effective access without the implementation of public policies that encourage the active search and monitoring of this population. This scenario demonstrates the influence of sociocultural, emotional, and structural barriers that interfere with the pursuit of healthcare. In this sense, the development of educational strategies, awareness campaigns, professional development strategies, and public policies aimed at reducing stigma and strengthening access to healthcare services becomes essential.