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Related Concept Videos

Disorders of the Male Reproductive System01:20

Disorders of the Male Reproductive System

351
Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
351
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Prostate-specific Antigen And Prostate Cancer In Gender-affirming Hormone Therapy For Transgender Or Nonbinary Individuals

Prostate-Specific Antigen and Prostate Cancer in Gender-Affirming Hormone Therapy for Transgender or Nonbinary Individuals

Kylie M Morgan1, Leah N Deshler1, Michelle D Tibbs1

  • 1Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Health Equity and Education Research (CHEER), La Jolla, California; Veterans Affairs San Diego, La Jolla, California.

International Journal of Radiation Oncology, Biology, Physics
|October 2, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Gender-affirming hormone therapy significantly lowers prostate-specific antigen (PSA) levels in transgender and nonbinary individuals (TGNB). Despite decreased PSA, TGNB individuals remain at risk for prostate cancer, warranting further investigation into screening protocols.

Area of Science:

  • Endocrinology
  • Oncology
  • Transgender Health

Background:

  • Prostate-specific antigen (PSA) is a key biomarker for prostate health.
  • The impact of gender-affirming hormone therapy (GAHT) on PSA levels and prostate cancer risk in transgender and nonbinary (TGNB) individuals assigned male at birth is not well understood.

Purpose of the Study:

  • To investigate the effects of GAHT on PSA levels in TGNB individuals.
  • To assess prostate cancer incidence in TGNB individuals compared to cisgender men.

Main Methods:

  • A cohort of 1024 TGNB individuals assigned male at birth who underwent PSA testing was matched with cisgender men by birth year.
  • PSA changes were analyzed using linear-mixed effects modeling.
  • Prostate cancer incidence was compared between TGNB individuals and cisgender men from age 50.

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Main Results:

  • Both non-gonadotrophin-releasing hormone (GnRH) agonist/antagonist therapy and GnRH therapy were associated with significantly lower PSA levels compared to cisgender men.
  • In TGNB individuals with pre- and post-hormone therapy PSA data, both therapy types led to a significant decrease in PSA.
  • Prostate cancer incidence from age 50 was lower in TGNB individuals (1.79 per 1000 patient-years) compared to cisgender men (4.02 per 1000 patient-years).

Conclusions:

  • GAHT is associated with substantial reductions in PSA levels among TGNB individuals.
  • TGNB individuals assigned male at birth continue to be at risk for prostate cancer.
  • Further research is needed to determine optimal biopsy thresholds and whether observed decreased incidence is due to ascertainment bias or a true effect of hormone therapy.