Hormone therapy linked to lower prostate cancer risk in transgender women — but screening gaps remain. A new meta-analysis found transgender women on gender-affirming hormone therapy (GAHT) had a 77.6% lower prostate cancer incidence compared to cisgender men. Researchers warn that PSA thresholds aren't validated for this population, and individual risk shouldn't be dismissed based on population-level data alone.
A systematic review and meta-analysis published in European Urology Oncology found that transgender women receiving gender-affirming hormone therapy (GAHT) have a substantially lower rate of prostate cancer compared to cisgender men — but researchers are urging clinicians not to let that statistic create a false sense of security at the individual patient level.
The analysis pooled data from 9 studies involving 54,342 transgender women on GAHT. Of those, 679 developed prostate cancer, with a pooled incidence rate of 22.9 per 100,000 person-years — compared to 98.1 per 100,000 person-years in cisgender men from the same cohorts.
By the Numbers:
Why it matters: Despite the lower overall incidence, validated PSA thresholds and gender-inclusive screening protocols don't yet exist for this population — meaning some high-risk cases could be missed. Researchers are calling for prospective studies and cancer registries that include explicit gender-identity fields.
