Prostate Cancer Screening and Diagnoses in the Transfeminine Population

To examine the frequency and rate at which transfeminine patients receive prostate-specific antigen testing compared to a matched cisgender cohort.

Patients with prostates who had encounters in our health system, are currently age 46 or older, and who are alive were included in our study. Transfeminine patients were identified through diagnosis codes and chart review. A 1:5 matched cohort was created based on patient age, race, and area deprivation index. Conditional logistic regression was done to compare odds of receiving any testing and Poisson regression was done to compare the total tests.

A total of 275,112 patients were included in the study, of which 315 were confirmed to be transfeminine. A well-matched 1:5 propensity-matched cohort was created. Our results suggest that transfeminine patients were 0.28 (95% CI 0.20-0.38, P <.001) times as likely as cisgender patients to receive at least 1 PSA test at our institution and received only 32% (95% CI 27%-37%, P <.001) as many total PSA tests.

Until more is known about the best practices for PSA testing in the transfeminine population, these patients should receive PSA testing. However, our results suggest that transfeminine patients are significantly less likely to receive any testing and significantly fewer tests in their lifetimes, which may represent a significant healthcare disparity.