Study identifies disparities in prostate cancer screening for transgender women

A recent study published in Urology found that prostate-specific antigen (PSA) screening rates for privately-insured patients were significantly lower among transgender women compared with cisgender men.1

The proportion of transgender women who received at least 1 PSA screening test during the study period was 32.6%, compared with 41.8% in cisgender men.

“Our study has shed light on a major health care disparity for transgender women. The findings reveal that this group is significantly less likely to receive prostate cancer screenings compared [with] cisgender men,” said lead author Hayley Premo, in correspondence with Urology Times®. Premo is a medical student at Duke University School of Medicine in Durham, North Carolina.

The study authors retrospectively identified 2957 transgender women from the IBM MarketScan database who were 40 to 80 years of age and had no prior diagnosis of prostate malignancy. A control cohort of 14,278,025 cisgender men with similar eligibility criteria was also included for comparative analysis. Yearly analysis was conducted from 2013 to 2019.

The data showed that yearly PSA screening rates lag for transgender women compared with cisgender men. The gap was statistically significant in all years except 2017, where rates for transgender women were 26.9% compared with 29.1% in the control cohort. Overall, the proportion of transgender women who received at least 1 PSA screening test during the study period was 32.6%, compared with 41.8% in cisgender men.

When stratified by age group and adjusting for year, the gap in screening was shown to narrow as age increases. Transgender women aged 40 to 54 had a 26% lower rate of PSA screening when compared with controls, and transgender women aged 55 to 69 had a 17% lower PSA screening rate. Conversely, investigators found an 88% higher rate of screening among transgender women aged 70 to 80.

Investigators also analyzed demographic trends, and found that hormone use was associated with increased screening rates, and residing in the North Central/Northeast/West regions as well as having gender-affirming surgery were associated with decreased PSA screening rates.

“There is a lack of information regarding the prevalence and implications of this disease in transgender women, and this highlights the crucial need for further research into prevention, detection, and treatment. To improve health care outcomes for transgender individuals, it is essential that we address the disparities they face and work toward providing equal care,” concluded Premo.

Reference

1. Premo H, Gordee A, Lee HJ, Scales Jr. CD, Moul JW, Peterson A. Disparities in prostate cancer screening for transgender women: An analysis of the MarketScan Database. Urology. [published online ahead of print March 25, 2023. Accessed April 17, 2023. doi:10.1016/j.urology.2023.03.016.