PD20-04 TRENDS IN PROSTATE CANCER DIAGNOSIS IN TRANSGENDER WOMEN: A NATIONAL STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD20-04 TRENDS IN PROSTATE CANCER DIAGNOSIS IN TRANSGENDER WOMEN: A NATIONAL STUDY Farnoosh Nik-Ahd, Amanda De Hoedt, Christi Butler, Jennifer T. Anger, Peter R. Carroll, Matthew R. Cooperberg, and Stephen J. Freedland Farnoosh Nik-AhdFarnoosh Nik-Ahd More articles by this author , Amanda De HoedtAmanda De Hoedt More articles by this author , Christi ButlerChristi Butler More articles by this author , Jennifer T. AngerJennifer T. Anger More articles by this author , Peter R. CarrollPeter R. Carroll More articles by this author , Matthew R. CooperbergMatthew R. Cooperberg More articles by this author , and Stephen J. FreedlandStephen J. Freedland More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003286.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Little is known about prostate cancer (CaP) screening and diagnosis in transgender women (TW). To date, only 10 case reports have been published on CaP in this population. In this study, we sought to understand the clinical characteristics and CaP screening history at prostate cancer diagnosis among TW. METHODS: This is a retrospective study of all patients ages 18 and older across the entire Veterans Affairs Health System (VAHS) in the United States from January 2000-February 2022 with both an ICD code for CaP and at least one ICD code related to transgender identity. Detailed chart review was performed to stratify patients by gender-affirming hormone usage. Data abstracted included PSA at diagnosis, consistency of PSA screening, clinical stage, bilateral orchiectomy status, biopsy grade group, and primary treatment modality. Consistent PSA screening was defined as screening at least every 2 years between ages 55-69, as per American Urological Association screening guidelines. RESULTS: After detailed chart review, 133 TW with CaP were identified. After stratification by use of estrogen for gender-affirming hormone therapy, 99 had no prior estrogen use, 15 were formerly on estrogen but had stopped prior to diagnosis, and 19 were actively on estrogen at diagnosis. Only 25-33% of TW were undergoing consistent guideline-based PSA screening regardless of estrogen usage. Median duration of estrogen use was 44 months and 11 months, respectively, for those formerly on estrogen and those actively on estrogen at diagnosis. Among all patients, PSA, PSA density, and grade group were highest among those on estrogen at diagnosis followed by those formerly on estrogen. CONCLUSIONS: This is the largest study of CaP in TW to date. Nonetheless, our study population of 133 CaP patients was much lower than expected given the estimated TW population within the VAHS. The degree to which this represents the effects of estrogen therapy on CaP diagnosis and/or dramatic underdiagnosis due to limited guideline-based PSA screening even among those with CaP requires further study. Future work should aim to understand the incidence and long-term outcomes of CaP in this population and establish guidelines for CaP screening for those on gender-affirming hormone therapy. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e584 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Farnoosh Nik-Ahd More articles by this author Amanda De Hoedt More articles by this author Christi Butler More articles by this author Jennifer T. Anger More articles by this author Peter R. Carroll More articles by this author Matthew R. Cooperberg More articles by this author Stephen J. Freedland More articles by this author Expand All Advertisement PDF downloadLoading ...