Grading of Recommendations Assessment, Development and Evaluation (GRADE) summary of findings table for benefits and harms of breast screening for trans people (review 2)
| Population: asymptomatic adult trans people with mean age of 43.1 (SD 10.4) yr Intervention: breast screening with mammography, MRI, ultrasonography, clinical breast examination or breast self-examination | |||
|---|---|---|---|
| Outcome; population | Effect | No. of participants (no. of studies) | Certainty of evidence (GRADE) |
| Trans men | |||
| Benefits* | No primary research evidence identified | ||
| Harms† | |||
| Trans women | |||
| Benefits* | No primary research evidence identified | ||
| Overdiagnosis, false-positive screen and patient-reported anxiety | |||
| Painfulness of mammography‡§ | Mean scores ranged from 1.7 (SD 2.1) to 2.0 (SD 2.3)¶ | 50 (1) (23) | ⊕○○○ Very low**†† |
| Painfulness of ultrasonography‡§ | Mean score 0.5 (SD 1.2)‡‡ | 50 (1) (23) | ⊕○○○ Very low**†† |
Note: MRI = magnetic resonance imaging, SD = standard deviation.
↵* Breast-cancer–specific mortality, all-cause mortality, cancer detection rate, interval cancer rate, sensitivity and specificity.
↵† Overdiagnosis, false-positive screen, patient-reported anxiety and patient-reported pain.
↵‡ Assessed by participant using a visual analogue scale ranging from 0 to 10.
↵§ Performed by a single experienced radiologist.
↵¶ Two postmammography assessments of participant-experienced pain were conducted, 1 by a radiologist and the other by a study nurse.
The corresponding mean scores were 1.7 and 2.0.
↵** Very low certainty rating = we have very little confidence in the effect estimate, and the true effect is likely to be substantially different from the effect estimate.
↵†† The evidence was downgraded owing to serious concerns regarding the observational nature of the study design and risk of bias.
Detailed Grading of Recommendations Assessment, Development and Evaluation assessments are provided in Supplementary Table S6, Appendix 4.
↵‡‡ The study personnel responsible for administering the assessment of experienced pain were not reported.