Prostate cancer risk for transgender women

Transgender women keep their prostates even after gender-affirming surgery, but the extent to which they remain at risk of prostate cancer has been unclear.

The study drew on 22 years of data from the Veterans Affairs Health System. Although the sample size was necessarily small, it is still the largest study of its kind. Transgender people often face discrimination and disparities, and there has been a growing acknowledgement of the complexities involved in their health care.

The study found 155 confirmed transgender women with prostate cancer and stratified them according to whether they had used estrogen: 116 had never used estrogen, 17 had once used estrogen but stopped before they were diagnosed with prostate cancer, and 22 were actively on estrogen.

The median age of diagnosis was 61 years, and 88 percent of the patients were white. Just 8 percent were Black, suggesting possible disparities affecting this group. Black cisgender men are at heightened risk of being diagnosed with and dying from prostate cancer.

The authors found that prostate cancer occurs in transgender women more frequently than published accounts might suggest, with about 14 prostate cancer cases per 10,000 transgender women.

Reference:

Farnoosh Nik-Ahd, et al,Journal of the American Medical Association,