Introduction: Transgender and non-binary (TGNB) individuals face many barriers to accessing healthcare , and appropriate health screenings are often missed. Prostate cancer screening among the TGNB designated male at birth (DMAB) population is not well reported. This study examines screening patterns among TGNB DMAB patients at an urban tertiary care institution Methods: A system-wide data search was performed from March 2019-February 2021 to flag any encounters containing a diagnosis code for gender dysphoria, notation within structured demographic gender identity fields, or a clinical note with TGNB-related keyword. Charts were reviewed and all patients conclusively TGNB DMAB over the age of 40 were included as eligible for prostate-specific antigen (PSA) screening. Rates of screening as defined by any PSA were calculated according to AUA guidelines. Results: Overall 190 patients had complete data and were eligible. Four patients were excluded from screening analysis with a history of prostate cancer; only 1 was on hormone therapy at the time of diagnosis. The median (IQR) age was 55.5 [48.3, 65.5] years and 19.2% African American race. The majority identified as transgender women (n=189, 98.4%). One hundred and fifty-five (80.7%) patients were on estrogen therapy. Ninety-one (47.4%) patients had received some type of gender-affirming surgery, with 20% orchiectomy and 16% vaginoplasty. The rate of lifetime prostate cancer screening after transition was 26.6% for patients >40 years of age and 20.6% for those 55-69 years of age. Multiple regression analysis of predictor variables including employment status, insurance status, education, hormone therapy, and race revealed no significant association with any prostate cancer screening being performed Conclusions: Prostate cancer screening rates in the TGNB DMAB population are lower than institutional and national rates for cisgender men. Further investigation into barriers as well as appropriate screening protocols specific to the TGNB population is needed. SOURCE OF Funding: None
