The Burden of Cancer and Precancerous Conditions Among Transgender Individuals in a Large Health Care Network: Retrospective Cohort Study

作者：Shuang Yang, Yongqiu Li, Christopher W. Wheldon, Jessica Y. Islam, Mattia Prosperi, Thomas J. George, Elizabeth Shenkman, Fei Wang, Jiang Bian, Yi Guo · 发表于：JMIR Cancer · 年份：2025 · DOI：10.2196/73843 · 被引用次数：1 · 研究领域：LGBTQ Health, Identity, and Policy、BRCA gene mutations in cancer、Epigenetics and DNA Methylation

Background: Disparities in cancer burden between transgender and cisgender individuals remain an underexplored area of research. Objective: This study aimed to examine the cumulative incidence and associated risk factors for cancer and precancerous conditions among transgender individuals compared with matched cisgender individuals. Methods: We conducted a retrospective cohort study using patient-level electronic health record (EHR) data from the University of Florida Health Integrated Data Repository between 2012 and 2023. Transgender individuals were identified using a validated, computable phenotype algorithm that used structured data and clinical notes. They matched 1:10:10 by age and calendar year of index date with cisgender women and cisgender men. The index date was the first transgender-related record for transgender individuals and a matched diagnosis date for cisgender controls. Primary outcomes included new-onset cancers associated with human papillomavirus, human immunodeficiency virus, tobacco, alcohol, lung, breast, and colorectal sites. Secondary outcomes were precancerous conditions related to the same cancer types. We calculated cumulative incidence rates and conducted time-to-event analyses using the Fine-Gray method, treating all-cause death as a competing risk, to assess associations between gender identity and the presence of cancer or precancer, adjusting for demographic and clinical covariates. Interaction analyses evaluated if associations between can...