To systematically review the evidence on prostate cancer (PCa) in transgender women (TGW).
A total of 25 studies were included. Fourteen articles were case reports or case series describing 21 TGW with PCa; 11 papers focused primarily on assessing the incidence or screening of PCa in TGW. The median (range) age of patients with PCa was 63 (45-78) years. Median (range) PSA at diagnosis was 7.5 (0.4-1710) ng/mL. Prostate biopsy detected ISUP 3-5 in 10 (67%) cases. T3-4 stages were described in 7 (64%) patients. Three (14.3%) cases of nodal involvement and 2 (9.5%) of metastases were reported at diagnosis. First-line therapy included radical prostatectomy or radiotherapy ± androgen deprivation therapy in 14 (74 %) subjects. Median (range) follow-up was 24 (2-120) months. A good response to first-line therapy was recorded in 8 (47.1%) cases. Median (range) incidence of PCa in TGW was 44.1 (4.34-140) cases per 100,000 person-years. PCa was significantly less frequent in TGW than in cisgender males (HR 0.4, 95% CI 0.2-0.9). Risk of death after PCa diagnosis was significantly higher in TGW compared to cisgender males (HR 1.91, 95% CI 1.06-3.45). TGW had lower lifetime PSA rates (48% vs. 64.6%, p = 0.048) than cisgender males. Few cases of PCa in TGW are currently reported. PCa seems significantly less frequent in TGW than in cisgender males; however, some data suggest a possible higher mortality in this cohort. TGW appear to have less access to PSA testing than cisgender men.
Current oncology reports. 2023 Nov 01 [Epub ahead of print]
Celeste Manfredi, Francesco Ditonno, Antonio Franco, Eugenio Bologna, Leslie Claire Licari, Davide Arcaniolo, Andrea Tubaro, Cosimo De Nunzio, Alessandro Antonelli, Marco De Sio, Edward E Cherullo, Riccardo Autorino
Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA., Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy., Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy., Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Department of Urology, Rush University Medical Center, 1725 W Harrison St, Professional Building - Suite 970, Chicago, IL, 60612, USA. .