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 < .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 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.

中文翻译：

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跨性别女性前列腺癌的患病率和与前列腺癌相关的因素


重要性关于跨性别女性前列腺癌 （prostate cancer， 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。目的评估美国跨性别女性 PCa 患病率，评估跨性别人群中 PCa 相关因素，以及与 PCa 继发于生化复发 （BCR） 和骨转移 （BM） 相关的因素。设计、设置和参与者2023 年 10 月进行了一项回顾性队列研究，涵盖 2011 年至 2022 年期间（12 年分析）。该研究基于一个大型的、全付款人索赔、去标识化的美国数据库 （PearlDiver Mariner）。在分配变状态代码之前被确定为男性的跨性别女性也被包括在内。在跨性别女性人群中检测到 PCa 患者。主要结局和测量 选择 PCa 诊断作为主要结局;选择 BCR 和 BM 作为次要结局。结果共纳入 95 460 例跨性别女性，平均 （SD） 年龄为 52.5 （9.4） 岁。在 589 例平均 （SD） 年龄为 66.8 （10.0） 岁的个体中诊断出 PCa （估计患病率，0.62%;95% CI，0.54%-0.77%）。年龄 （校正比值比 [OR]，1.10;95% CI，1.08-1.12;P < .001） 和家族史 （校正 OR，2.27;95% CI，1.60-4.92;P < .001） 与跨性别女性的 PCa 呈正相关。性别肯定激素治疗 （GAHT） 与跨性别女性的 PCa 呈负相关 （OR，0.60;95% CI，0.56-0.89;P < .001），但与 BCR 呈正相关 （OR，1.83;95% CI，1.21-2.86;P < .001） 和 BM （OR， 3.96;95% CI， 1.50-9.99;P < .001） 在 PCa 的跨性别人群中。结论和相关性这项队列研究发现，PCa 在跨性别女性中似乎相对罕见。GAHT 可能会降低跨性别患者患 PCa 的风险，但也可能会增加患有 PCa 的跨性别女性患 BCR 和 BM 的风险。需要进一步的研究来证实我们的发现。