What matters for the prevention of uterine and ovarian cancer is the presence of a uterus and/or ovaries and your individual risk factors, not legal gender.
The uterus and ovaries are internal reproductive organs located in the pelvis of people who were born with them and have not had them surgically removed.
Unlike breast, cervical and colorectal cancer, there are currently no screening tests that have been shown to improve outcomes for uterine or ovarian cancer in people at average risk. Early detection therefore relies on recognising symptoms and identifying individuals at increased risk who may benefit from specialist surveillance.
More information is provided below.
Do I need screening for uterine or ovarian cancer?
The uterus and ovaries are internal reproductive organs located in the pelvis of people who were born with them and have not had them surgically removed. If you have a uterus and/or ovaries and are not at increased risk, routine screening is generally not recommended.
You may be at increased risk if you have:
- a family history of uterine, ovarian or breast cancer, particularly in a close relative; or
- an inherited genetic variant associated with an increased risk of these cancers, such as BRCA1, BRCA2 or Lynch syndrome.
If you have concerns about your risk, discuss them with your GP or specialist. Together, you can decide whether surveillance or other preventive strategies are appropriate for you. Depending on your individual level of risk, surveillance may include:
- ultrasounds, and/or
- a CA-125 blood test
Gender-affirming genital surgery for AFAB anatomy
Gender-affirming surgical procedures vary. Some people do not have surgery, while others may have removal of the uterus, one or both ovaries, or both.
When surgery includes closure of the vaginal canal, the uterus is usually removed. However, removal of the ovaries is a separate decision, and one or both ovaries may be left in place.
If your uterus and both ovaries have been removed, you are no longer at risk of developing uterine or ovarian cancer. If your uterus or one or both ovaries remain, a residual risk remains.
If you are unsure which organs were removed during surgery, ask your healthcare provider.
Does testosterone therapy affect my risk?
Although testosterone usually stops menstrual bleeding, it does not completely stop the activity of the uterus. The long-term implications for uterine cancer risk are still being studied. If you have a uterus and/or ovaries, uterine and/or ovarian cancer can still occur.
New or unexpected vaginal bleeding after your periods have stopped should always be discussed with your healthcare provider.
General Considerations
The information in this website is meant to provide general guidance and education. It cannot replace a medical consultation that takes into account a person’s medical history, risk factors, and preferences.
Whether surveillance or diagnostic testing is appropriate depends on a person's individual risk factors, symptoms and preferences. These tests also have limitations and possible downsides that should be discussed with a healthcare provider.
