Posted: Wednesday, February 1, 2023
A recent article published in European Urology reported findings on the incidence of prostate cancer and the use of prostate-specific antigen (PSA) screening in transgender women. Farnoosh Nik-Ahd, MD, of the University of California, San Francisco, and colleagues performed a literature review of all PubMed publications through June 2022. Articles were reviewed to understand PSA screening practices and to provide incidence reports of prostate cancer in the transgender community. Their findings revealed that transgender women with prostate cancer may have a more aggressive disease, since survival in this population was worse in comparison with cis-gender patients.
“Even after gender-affirming surgery, [transgender women] retain their prostate and, as such, [prostate cancer screening] in [transgender women] remains an important part of their routine health-care maintenance,” stated Dr. Nik-Ahd and colleagues.
A comprehensive, narrative review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. A total of 27 publications met inclusion criteria and were included in this review article. Evidence was synthesized and prostate cancer incidence, PSA screening patterns and the role of gender-affirming hormone therapy (GAHT), and gender-affirming surgery were reported.
Overall findings revealed that the prevalence of prostate cancer in transgender women remains unknown; however, one study revealed that survival among transgender patients with prostate cancer was worse in comparison with cis-gender patients. Comprehensive reviews revealed 10 documented cases of transgender women with prostate cancer; all 10 patients had undergone GAHT before their diagnosis, and 9 patients had elevated PSA levels at diagnosis.
The researchers’ findings also revealed lower rates of shared decision-making and screening in the transgender population in comparison with cis-gender and heterosexual individuals. In addition, there was a lack of guideline recommendations for screening in transgender individuals, suggesting the need for more research into ways to reduce these diagnostic disparities.
Disclosure: The study authors reported no conflicts of interest.