PSA Levels Very Low Among Transgender Women Receiving Estrogen

TUESDAY, July 9, 2024 (HealthDay News) — For transgender women receiving estrogen, the median prostate-specific antigen (PSA) level is 0.02 ng/mL, according to a research letter published online June 26 in the Journal of the American Medical Association.

Farnoosh Nik-Ahd, M.D., from the University of California, San Francisco, and colleagues determined PSA values among a nationwide cohort of transgender women without known prostate cancer receiving estrogen. The inclusion criteria were met by 210 patients who underwent 852 PSA tests.

The researchers found that the median PSA level was 0.02 ng/mL, and the 95th percentile value was 0.6 ng/mL. In 36 percent of patients, PSA levels were undetectable (23 and 49 percent of those without and with orchiectomy, respectively). In sensitivity analyses using first PSA level and the median of all PSA levels per patient, the PSA distributions were similar (median, 0.08 and 0.06 ng/mL; 95th percentile, 0.7 and 0.5 ng/mL). Within the cohort, the highest PSA level was 2.21 ng/mL.

“In this study, PSA values were very low among transgender women receiving estrogen, suggesting that the historic cut point of 4 ng/mL, often used as a threshold for further evaluation, is likely far too high a threshold for this population,” the authors write.

One author disclosed ties to the biopharmaceutical industry.

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