Prevalence and Factors Associated With Prostate Cancer Among Transgender Women.

IF 28.4 1区医学 Q1 Biochemistry, Genetics and Molecular Biology Jama Oncology Pub Date : 2024-10-03 DOI:10.1001/jamaoncol.2024.4335

Celeste Manfredi, Antonio Franco, Francesco Ditonno, Eugenio Bologna, Leslie Claire Licari, Costantino Leonardo, Alessandro Antonelli, Cosimo De Nunzio, Edward E Cherullo, Marco De Sio, Riccardo Autorino

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Abstract

Importance: Evidence on prostate cancer (PCa) in transgender women is very limited; data are needed to reduce gender disparities in both PCa knowledge and health care.

Objective: To 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 participants: A 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 measures: PCa diagnosis was selected as primary outcome; BCR and BM were chosen as secondary outcomes.

Results: A 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 < .001) and family history (adjusted OR, 2.27; 95% CI, 1.60-4.92; P < .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 < .001) but positively associated with BCR (OR, 1.83; 95% CI, 1.21-2.86; P < .001) and BM (OR, 3.96; 95% CI, 1.50-9.99; P < .001) in the transgender population with PCa.

Conclusions and relevance: This 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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变性女性中前列腺癌的患病率和相关因素。

重要性：有关变性女性患前列腺癌（PCa）的证据非常有限；需要数据来减少 PCa 知识和医疗保健方面的性别差异：评估美国变性女性中 PCa 的患病率，评估 PCa 的相关因素，以及变性人群中 PCa 继发生化复发（BCR）和骨转移（BM）的相关因素：2023 年 10 月进行了一项回顾性队列研究，研究时间跨度为 2011 年至 2022 年（12 年分析）。该研究基于一个大型的美国数据库（PearlDiver Mariner）。研究对象包括在变性身份代码分配前被确认为男性的变性女性。在变性女性人群中发现 PCa 患者：主要结果和测量指标：PCa 诊断被选为主要结果；BCR 和 BM 被选为次要结果：结果：共纳入 95 460 名变性女性，平均（标清）年龄为 52.5（9.4）岁。589人确诊为PCa，平均（标清）年龄为66.8（10.0）岁（估计患病率为0.62%；95% CI，0.54%-0.77%）。年龄（调整后的几率比 [OR]，1.10；95% CI，1.08-1.12；P 结论及相关性：这项队列研究发现，PCa 在变性女性中似乎并不常见。GAHT可能会降低变性患者罹患PCa的风险，但也可能会增加患有PCa的变性女性罹患BCR和BM的风险。我们需要进一步的研究来证实我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Jama Oncology Medicine-Oncology

CiteScore

37.50

自引率

1.80%

发文量

423

期刊介绍： At JAMA Oncology, our primary goal is to contribute to the advancement of oncology research and enhance patient care. As a leading journal in the field, we strive to publish influential original research, opinions, and reviews that push the boundaries of oncology science. Our mission is to serve as the definitive resource for scientists, clinicians, and trainees in oncology globally. Through our innovative and timely scientific and educational content, we aim to provide a comprehensive understanding of cancer pathogenesis and the latest treatment advancements to our readers. We are dedicated to effectively disseminating the findings of significant clinical research, major scientific breakthroughs, actionable discoveries, and state-of-the-art treatment pathways to the oncology community. Our ultimate objective is to facilitate the translation of new knowledge into tangible clinical benefits for individuals living with and surviving cancer.