(HealthDay News) — Prostate cancer among transgender women is not as rare as previous case reports suggest, according to a study published in the Journal of the American Medical Association.

The study included 449 patients with prostate cancer and transgender identity codes identified from electronic medical records within the Veterans Affairs health system (2000 to 2022).

The researchers found that 155 patients (35%) were confirmed transgender women with prostate cancer. This translates to an estimated 14 cases per year.

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All prostate cancers were detected via screening. At diagnosis, the patients had a median age of 61 years, 88% were White, the median prostate-specific antigen (PSA) level was 6.8 ng/mL, the median PSA density was 0.22 ng/mL/g, and 98% had not undergone bilateral orchiectomy.

Patients had stage T1 (45%) or T2 (55%) disease. Most had grade group 1 (43%) or 2 (23%) disease, but grade groups 3 (9%), 4 (11%), and 5 (14%) were represented as well.

Of the 155 patients, 116 never used estrogen, 17 formerly used estrogen, and 22 actively used estrogen at diagnosis. The median duration of estrogen use was 32 months among former and active estrogen users.

The percentage of patients with grade group 1 or 2 was 71% in non-estrogen users, 56% in former estrogen users, and 53% in active estrogen users. The percentage of patients with grade group 4 or 5 was 23% in non-estrogen users, 25% in former estrogen users, and 35% in active estrogen users.

The median PSA density was 0.21 ng/mL/g for non-estrogen users, 0.26 ng/mL/g for former users, and 0.31 ng/mL/g for active users.

“This case series demonstrated that prostate cancer occurs in transgender women and is not as rare as published case reports might suggest,” the researchers wrote. “However, rates were lower than expected based on prior prostate cancer incidence estimates in cisgender male veterans.”

One researcher disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text