DEI-04 PROSTATE CANCER IN TRANSGENDER WOMEN: A CONTEMPORARY ANALYSIS OF A WIDE U.S. DATABASE

You have accessJournal of UrologyDiversity, Equity & Inclusion Forum (DEI01)1 May 2024DEI-04 PROSTATE CANCER IN TRANSGENDER WOMEN: A CONTEMPORARY ANALYSIS OF A WIDE U.S. DATABASE Celeste Manfredi, Eugenio Bologna, Francesco Ditonno, Antonio Franco, Leslie Licari, Morgan Sturgis, Oren Feldman-Schultz, Marco De Sio, Ephrem Olweny, Srinivas Vourganti, Christopher Coogan, Edward Cherullo, and Riccardo Autorino Celeste ManfrediCeleste Manfredi , Eugenio BolognaEugenio Bologna , Francesco DitonnoFrancesco Ditonno , Antonio FrancoAntonio Franco , Leslie LicariLeslie Licari , Morgan SturgisMorgan Sturgis , Oren Feldman-SchultzOren Feldman-Schultz , Marco De SioMarco De Sio , Ephrem OlwenyEphrem Olweny , Srinivas VourgantiSrinivas Vourganti , Christopher CooganChristopher Coogan , Edward CherulloEdward Cherullo , and Riccardo AutorinoRiccardo Autorino View All Author Informationhttps://doi.org/10.1097/01.JU.0001008820.69436.91.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer (PCa) in transgender women (TGW) is an under-investigated topic, characterized by important psychosocial issues. This study aimed to evaluate the frequency and predictors of PCa in the transgender population and to describe characteristics and management of TGW with PCa. METHODS: We conducted a retrospective analysis based on the PearlDiver™ Mariner database. It is a commercially available, all-payer claims, deidentified, U.S. database, containing over 41 billion Health Insurance Portability and Accountability Act (HIPAA)-compliant patient records collected between 2011 and 2022. Specific International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes were used to identify population and outcomes in the database. The following data were described: number of TGW, age, PSA test performed, family history (FH) for PCa, orchiectomy, gender-affirming hormone therapy (GAHT), PCa diagnosis, PCa management, bone metastases, biochemical recurrence (BCR). PCa diagnosis was selected as primary outcome. The data was extracted, categorized, synthesized, and analyzed directly by the R-based software integrated into to the database. Th multivariable analysis was performed to evaluate the predictors of PCa, BCR, and bone metastases in TGW. RESULTS: A total of 95,460 TGW with a mean±SD age of 52.5±9.4 years were included. Only 5,953 (6.2%) had at least one PSA test. PCa was diagnosed in 589 (0.62%) TGW with a mean±SD age of 66.8±10 years. Thirty-nine (6.6%) TGW with PCa had a positive FH. Orchiectomy and GAHT were observed in 10 (1.7%) and 57 (9.7%) TGW with PCa, respectively. Time between onset of GAHT and PCa diagnosis was 63.2±41.9 months. Most common treatment after PCa diagnosis in TGW was RP alone (269, 45.7%). Multiple primary treatments were performed in 175 (29.7%) patients. ADT alone and AS were indicated in 17 (2.9%) and 20 (3.4%) TGW, respectively. Bone metastases were detected in 31 (5.3%) of TGW; BCR was diagnosed in 42 (7.1%) subjects. Age≥65 years (OR 1.103, 95% CI 1.095-1.111; p<0.001) and FH (OR 3.27, 95% CI 2.60-6.93; p<0.001) was positive predictors of PCa in TGW. GAHT was negative predictor of PCa in TGW (OR 0.64, 95% CI 0.58-0.85; p<0.001) but it was a positive predictor of BCR (OR 1.83, 95% CI 1.21-2.86; p<0.001) and bone metastases (OR 3.96, 95% CI 1.50-9.99; p<0.001). CONCLUSIONS: PCa in TGW seems relatively uncommon. TGW access to PSA screening appears limited. GAHT in TGW could reduce the risk of PCa but at the same time it would seem to increase its aggressiveness. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e288 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Celeste Manfredi More articles by this author Eugenio Bologna More articles by this author Francesco Ditonno More articles by this author Antonio Franco More articles by this author Leslie Licari More articles by this author Morgan Sturgis More articles by this author Oren Feldman-Schultz More articles by this author Marco De Sio More articles by this author Ephrem Olweny More articles by this author Srinivas Vourganti More articles by this author Christopher Coogan More articles by this author Edward Cherullo More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement PDF downloadLoading ...