Opportunity Awaits: Incorporating Human Papillomavirus Risk Factor and Vaccination Screening at Preoperative Visits for Patients Accessing Gender-Affirming Surgeries (GASs) [ID 1309]

INTRODUCTION: The transgender and gender-diverse population have a higher human papillomavirus (HPV) disease burden. With preoperative visits for bottom surgery being well attended, we explored the trends in assessment of HPV risk factors and prevention screening at these visits for opportunities to reduce disease burden. METHODS: A retrospective chart review of the University of Colorado Health electronic medical record was completed for patients with a diagnosis of gender dysphoria (F64.9) undergoing bottom surgery from January 2016 to June 2023. Preoperative encounters were queried for HPV vaccination status, cervical cancer screening, and sexual practices documentation. Cohort characteristics include age, race/ethnicity, and sex assigned at birth (SAaB). Descriptive statistical analysis was performed. RESULTS: A total of 166 patients were included in the review: 93.3% were SAaB female at birth, and 77% identified as Caucasian with the average age being 28.9. Only 3 (1.81%) patients had HPV vaccination status documented by a provider at their pre-op visit, whereas 61 (36.7%) patients had documentation in their vaccination record. One hundred twenty-four (74.6%) patients had no preoperative sexual practice screening; and only 15 (9.0 %) patients were screened for anal HPV risk factors during preoperative evaluation, with only 32 (19%) patients having documented risk factors in their social history. CONCLUSIONS/IMPLICATIONS: Most patients are not assessed for HPV risk factors at preoperative GAS visits. There is substantial opportunity to increase HPV vaccination and sexual practice screening during GAS preoperative visits to reduce disproportionate HPV-related disease burden in this population. Future directions include implementation of screening questionnaires and immunization at preoperative visits.