Nash Rebecca, Ward Kevin C, Jemal Ahmedin, Sandberg David E, Tangpricha Vin, Goodman Michael
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Cancer Epidemiol. 2018 Jun;54:1-6. doi: 10.1016/j.canep.2018.02.008. Epub 2018 Mar 9.
Transgender people and persons with disorders of sex development (DSD) are two separate categories of gender minorities, each characterized by unique cancer risk factors. Although cancer registry data typically include only two categories of sex, registrars have the option of indicating that a patient is transgender or has a DSD.
Data for primary cancer cases in 46 states and the District of Columbia were obtained from the North American Association of Central Cancer Registries (NAACCR) database for the period 1995-2013. The distributions of primary sites and categories of cancers with shared risk factors were examined separately for transgender and DSD patients and compared to the corresponding distributions in male and female cancer patients. Proportional incidence ratios were calculated by dividing the number of observed cases by the number of expected cases. Expected cases were calculated based on the age- and year of diagnosis-specific proportions of cases in each cancer category observed among male and female patients.
Transgender patients have significantly elevated proportional incidence ratios (95% confidence intervals) for viral infection induced cancers compared to either males (2.3; 2.0-2.7) or females (3.3; 2.8-3.7). Adult DSD cancer patients have a similar distribution of primary sites compared to male or female patients but DSD children with cancer have ten times more cases of testicular malignancies than expected (95% confidence interval: 4.7-20).
The proportions of certain primary sites and categories of malignancies among transgender and DSD cancer patients are different from the proportions observed for male or female patients.
跨性别者和性发育障碍（DSD）患者是两类不同的性别少数群体，各自具有独特的癌症风险因素。尽管癌症登记数据通常仅包括两种性别类别，但登记员可选择注明患者为跨性别者或患有DSD。
从北美中央癌症登记协会（NAACCR）数据库获取了1995 - 2013年期间46个州和哥伦比亚特区原发性癌症病例的数据。分别检查了跨性别者和DSD患者中具有共同风险因素的癌症原发部位和类别分布，并与男性和女性癌症患者的相应分布进行比较。通过将观察到的病例数除以预期病例数来计算比例发病率。预期病例数是根据男性和女性患者中各癌症类别中观察到的按年龄和诊断年份特定的病例比例计算得出的。
与男性（2.3；2.0 - 2.7）或女性（3.3；2.8 - 3.7）相比，跨性别患者因病毒感染诱发癌症的比例发病率显著升高（95%置信区间）。成年DSD癌症患者的原发部位分布与男性或女性患者相似，但患有癌症的DSD儿童睾丸恶性肿瘤病例数比预期多十倍（95%置信区间：4.7 - 20）。
跨性别和DSD癌症患者中某些原发性部位和恶性肿瘤类别的比例与男性或女性患者中观察到的比例不同。
