Prostate Cancer in Transgender Women: Epidemiology, Clinical Characteristics, and Management Challenges

Manfredi, Celeste; Ditonno, Francesco; Franco, Antonio; Bologna, Eugenio; Licari, Leslie Claire; Arcaniolo, Davide; Tubaro, Andrea; De Nunzio, Cosimo; Antonelli, Alessandro; De Sio, Marco; Cherullo, Edward E.; Autorino, Riccardo

doi:10.1007/s11912-023-01470-w

Cited by 10 publications

(4 citation statements)

References 43 publications

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“…Previous literature has consistently established that PCa is less common among TW, however the extent of this reduction has not been well-defined [4]. A significant contribution to the field comes from the Netherlands by Di Nie et al, where a retrospective cohort study of 2281 trans women demonstrated a fivefold lower incidence of prostate cancer among those on HT [2].…”

Section: Discussionmentioning

confidence: 99%

Incidence of prostate cancer in transgender women in the US: a large database analysis

Loria,

Gilbert,

Tabernacki

et al. 2024

Prostate Cancer Prostatic Dis

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The risk of prostate cancer among transgender women undergoing medical and surgical gender-affirming interventions remains unclear, though up to a fivefold decreased risk has been reported in comparison to cisgender men. In this study, we conducted a comparative analysis of the risk of prostate cancer among transgender women (TW) using data from TriNetX, a large database, versus SEER. Our findings indicate that, overall, transgender women exhibited a 2.56-fold lower risk of prostate cancer compared to cisgender men. Specifically, among TW on hormone therapy between ages 50–64, we observed a 2.06-fold decrease in risk. Contrary to the previous perception of prostate cancer being rare in transgender women, our study suggests that it may not be as uncommon as previously believed.

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Section: Discussionmentioning

confidence: 99%

Incidence of prostate cancer in transgender women in the US: a large database analysis

Loria,

Gilbert,

Tabernacki

et al. 2024

Prostate Cancer Prostatic Dis

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“…A nonsystematic review published in 2021 and a systematic review published in 2023 summarized the available evidence on the incidence of PCa amongst TGD people [12,13]. Within the limitations of the evidence (low level, mainly case reports and case series) the incidence of PCa was shown to be lower in TGD individuals compared to cisgender male counterparts.…”

Section: Incidencementioning

confidence: 99%

“…To avoid repetition, a detailed description of the included studies is not provided here, but is summarized in the table below (Table 1) [12,13].…”

Section: Incidencementioning

confidence: 99%

“…Those diagnosed with PCa who are taking GAHT have already undergone pharmacological castration and PCa in these individuals should be considered resistant to castration. Oestrogens may select aggressive PCa in the long term, with androgen-independent tumours that are often poorly differentiated [13].…”

Section: Diagnosis and Management Of Prostate Cancer In Transgender A...mentioning

confidence: 99%

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Urologic oncology considerations in transgender and gender diverse patients

Tinajero,

Rashid

2024

Current Opinion in Urology

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Purpose of review This review delves into the pressing issue of urologic oncology considerations within the transgender and gender-diverse (TGD) community. With estimates suggesting that TGD individuals constitute 0.3 to 0.5% of adults worldwide, and this number steadily rising, our review examines the barriers that impede the delivery of excellent quality care, particularly in the context of cancer diagnosis and treatment. Recent findings Recent findings highlight disparities in cancer screening, diagnosis, and treatment access for TGD individuals. These challenges are compounded by a dearth of research and the failure of healthcare systems to account for gender identity and its nuances in data collection. Main themes in the literature include the impact of gender-affirming hormone therapy and surgery on cancer risk, challenges in prostate cancer screening and management, and considerations pertinent to testicular and other urological cancers in TGD patients. Summary The implications for clinical practice and research are profound and emphasize the need for multidisciplinary approaches that cater to the unique healthcare needs of TGD individuals. This includes comprehensive strategies for inclusive and accurate data collection, alongside the development of evidence-based guidelines for cancer screening and management tailored specifically to this population.

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Prevalence and Factors Associated With Prostate Cancer Among Transgender Women

Manfredi,

Franco,

Ditonno

et al. 2024

JAMA Oncol

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ImportanceEvidence on prostate cancer (PCa) in transgender women is very limited; data are needed to reduce gender disparities in both PCa knowledge and health care.ObjectiveTo evaluate the prevalence of PCa among transgender women in the US and assess the factors associated with PCa, and factors associated with biochemical recurrence (BCR) and bone metastases (BM) secondary to PCa in the transgender population.Design, Setting, and ParticipantsA retrospective cohort study was conducted in October 2023, covering the period between 2011 and 2022 (12-year analysis). The study was based on a large, all-payer claims, deidentified, US database (PearlDiver Mariner). Transgender women who were identified as male before assignment of transsexual status codes were included. Patients with PCa were detected in the transgender women population.Main Outcomes and MeasuresPCa diagnosis was selected as primary outcome; BCR and BM were chosen as secondary outcomes.ResultsA total of 95 460 transgender women with a mean (SD) age of 52.5 (9.4) years were included. PCa was diagnosed in 589 individuals with a mean (SD) age of 66.8 (10.0) years (estimated prevalence, 0.62%; 95% CI, 0.54%-0.77%). Age (adjusted odds ratio [OR], 1.10; 95% CI, 1.08-1.12; P &lt; .001) and family history (adjusted OR, 2.27; 95% CI, 1.60-4.92; P &lt; .001) were positively associated with PCa in transgender women. Gender-affirming hormone therapy (GAHT) was negatively associated with PCa in transgender women (OR, 0.60; 95% CI, 0.56-0.89; P &lt; .001) but positively associated with BCR (OR, 1.83; 95% CI, 1.21-2.86; P &lt; .001) and BM (OR, 3.96; 95% CI, 1.50-9.99; P &lt; .001) in the transgender population with PCa.Conclusions and RelevanceThis cohort study found that PCa appeared to be relatively uncommon in transgender women. GAHT may reduce the risk of PCa in transgender patients, but it may also increase the risk of BCR and BM in transgender women with PCa. Further studies are needed to confirm our findings.

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Prostate Cancer in Transgender Women: Epidemiology, Clinical Characteristics, and Management Challenges

Cited by 10 publications

References 43 publications

Incidence of prostate cancer in transgender women in the US: a large database analysis

Incidence of prostate cancer in transgender women in the US: a large database analysis

Urologic oncology considerations in transgender and gender diverse patients

Prevalence and Factors Associated With Prostate Cancer Among Transgender Women

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