Objective
To describe the prevalence of PSA screening amongst transgender women. A transgender
individual is someone whose gender identity differs from their birth sex or the societal
norms of that assigned sex. There are no formal guidelines regarding PSA screening
in transgender women, even though they retain prostatic tissue throughout the gender-affirming
process, and there is a lack of existing data to adequately inform clinical practice.
Methods
We identified a cohort of transgender women in the IBM MarketScan dataset using ICD
codes. The patient’s eligibility for inclusion was determined on an annual basis for
the years 2013-2019. For each year, we required continuous enrollment, 3 months of
post-transgender diagnosis follow-up, and aged 40-80 without a prior diagnosis of
prostate malignancy. This cohort was compared to cisgender men with similar eligibility
criteria. The proportions of individuals undergoing PSA screening were compared using
log-binomial regression.
Results
A group of 2957 transgender women met the inclusion criteria. We saw significantly
lower PSA screening rates among transgender individuals for ages 40-54 and 55-69,
but higher rates within the age group 70-80 (P < .001 for all).
Conclusion
This is the first study evaluating PSA screening rates for insured transgender women.
While the rates for screening in transgender women over the age of 70 are higher,
the overall rate of screening for all other age groups lags below the general population
in this dataset. Further investigation is necessary to provide equitable care for
the transgender community.
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Article info
Publication history
Published online: March 25, 2023
Accepted:
March 13,
2023
Received:
August 10,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Financial Disclosure: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
