Prostate cancer in transgender women in the Veterans Affairs Health System, 2000-2022

Transgender women retain their prostate even after gender-affirmation surgery and thus remain at risk of prostate cancer. A large case series of transgender women with prostate cancer within the Veterans Affairs healt system demonstrated that prostate cancer among transgender women is not as rare as published case reports might suggest, although rates were lower than expected based on prostate cancer incidence estimates in cisgender male veterans. Although limited numbers precluded formal statistical comparisons, transgender women receiving estrogen at diagnosis had the most aggressive disease (highest PSA density and proportion of biopsy grade group 5).