关于变性女性患前列腺癌（PCa）的证据非常有限；需要数据来减少 PCa 知识和医疗保健方面的性别差异。评估美国跨性别女性中 PCa 的患病率，并评估与 PCa 相关的因素，以及与生化复发 (BCR) 和骨转移 (BM) 相关的因素在跨性别人群中继发于 PCa。2023 年 10 月进行了一项回顾性队列研究，涵盖 2011 年至 2022 年期间（12 年分析）。该研究基于一个大型、全付款人索赔、去识别化的美国数据库（PearlDiver Mariner）。在分配变性身份代码之前被识别为男性的变性女性也被包括在内。 PCa患者在跨性别女性人群中检出。选择PCa诊断作为主要结局；选择 BCR 和 BM 作为次要结果。总共纳入了 95460 名平均 (SD) 年龄为 52.5 (9.4) 岁的跨性别女性。 589 名患者被诊断出 PCa，平均 (SD) 年龄为 66.8 (10.0) 岁（估计患病率，0.62%；95% CI，0.54%-0.77%）。年龄（调整后优势比 [OR]，1.10；95% CI，1.08-1.12；P < .001）和家族史（调整后 OR，2.27；95% CI，1.60-4.92；P < .001）与变性女性中的前列腺癌。性别肯定激素治疗 (GAHT) 与跨性别女性的 PCa 呈负相关（OR，0.60；95% CI，0.56-0.89；P<0.001），但与 BCR 呈正相关（OR，1.83；95% CI，1.21- 2.86；P< .001）和 BM（OR，3.96；95% CI，1.50-9.99；P< .001）在患有 PCa 的跨性别人群中。这项队列研究发现，PCa 在跨性别女性中似乎相对罕见。 GAHT 可能会降低跨性别患者患 PCa 的风险，但也可能增加患有 PCa 的跨性别女性发生 BCR 和 BM 的风险。需要进一步的研究来证实我们的发现。

Evidence on prostate cancer (PCa) in transgender women is very limited; data are needed to reduce gender disparities in both PCa knowledge and health care.To evaluate the prevalence of PCa among transgender women in the US and assess the factors associated with PCa, and factors associated with biochemical recurrence (BCR) and bone metastases (BM) secondary to PCa in the transgender population.A retrospective cohort study was conducted in October 2023, covering the period between 2011 and 2022 (12-year analysis). The study was based on a large, all-payer claims, deidentified, US database (PearlDiver Mariner). Transgender women who were identified as male before assignment of transsexual status codes were included. Patients with PCa were detected in the transgender women population.PCa diagnosis was selected as primary outcome; BCR and BM were chosen as secondary outcomes.A total of 95 460 transgender women with a mean (SD) age of 52.5 (9.4) years were included. PCa was diagnosed in 589 individuals with a mean (SD) age of 66.8 (10.0) years (estimated prevalence, 0.62%; 95% CI, 0.54%-0.77%). Age (adjusted odds ratio [OR], 1.10; 95% CI, 1.08-1.12; P < .001) and family history (adjusted OR, 2.27; 95% CI, 1.60-4.92; P < .001) were positively associated with PCa in transgender women. Gender-affirming hormone therapy (GAHT) was negatively associated with PCa in transgender women (OR, 0.60; 95% CI, 0.56-0.89; P < .001) but positively associated with BCR (OR, 1.83; 95% CI, 1.21-2.86; P < .001) and BM (OR, 3.96; 95% CI, 1.50-9.99; P < .001) in the transgender population with PCa.This cohort study found that PCa appeared to be relatively uncommon in transgender women. GAHT may reduce the risk of PCa in transgender patients, but it may also increase the risk of BCR and BM in transgender women with PCa. Further studies are needed to confirm our findings.