Prostate Cancer Screening and Diagnoses in the Transfeminine Population.

Area of Science:

• Urology
• Health Disparities
• Transgender Health

Background:

• Prostate-specific antigen (PSA) testing is a common screening method for prostate cancer.
• Understanding screening patterns in diverse populations, including transgender individuals, is crucial for equitable healthcare.
• Limited data exists on PSA testing rates among transfeminine patients.

Purpose of the Study:

• To compare the frequency and rate of PSA testing in transfeminine patients versus a matched cisgender cohort.
• To identify potential disparities in prostate cancer screening for transgender individuals.

Main Methods:

• Retrospective study including 275,112 patients with prostates aged 46+.
• Transfeminine patients identified via diagnosis codes and chart review (n=315).
• A 1:5 propensity-matched cohort was created based on age, race, and area deprivation index.
• Conditional logistic and Poisson regression analyses were used to compare testing rates and total tests.

Main Results:

• Transfeminine patients were significantly less likely to receive at least one PSA test (0.28 times as likely) compared to cisgender patients.
• Transfeminine patients received fewer total PSA tests (32% of the rate) than their cisgender counterparts.
• All comparisons showed statistically significant differences (P < .001).

Conclusions:

• Transfeminine patients experience significantly lower rates of PSA testing, suggesting a potential healthcare disparity.
• Current evidence does not support withholding PSA testing from transfeminine individuals.
• Further research is essential to determine optimal prostate cancer screening protocols for the transfeminine population.