Ovarian Cancer Associated with Testosterone Supplementation in a Female-to-Male Transsexual Patient

Dizon, Don S.; Tejada-Bergés, Trevor; Koelliker, Susan; Steinhoff, Margaret M.; Granai, C.O.

doi:10.1159/000094097

Cited by 83 publications

(56 citation statements)

References 9 publications

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“…In transmen, published case reports describe cancers of the breast, ovaries, cervix, vagina, and endometrium (17,18,34,35,44,45,(64)(65)(66)(67)(68).…”

Section: Possible Effects Of Cross-sex Hormonesmentioning

confidence: 99%

“…All 3 cases received testosterone therapy, 1 had a hysterectomy and a phalloplasty, and all 3 underwent a mastectomy (18,67). Only 2 cases were tested for the endometrial epidermal growth factor receptor and in both cases the results were positive (67).…”

Section: Possible Effects Of Cross-sex Hormonesmentioning

confidence: 99%

“…Whereas cancer among transgender people is listed among research priorities (10), most of the concerns pertaining to the occurrence and outcomes of malignant tumors in this population are based on anecdotal evidence or on the general considerations of possible disease mechanisms (13)(14)(15)(16)(17)(18). The high quality empirical data assessing cancer incidence and mortality among transgender people are lacking primarily because of an absence of large-scale prospective studies of this population (19).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cancer in Transgender People: Evidence and Methodological Considerations

Braun

Nash

Tangpricha

et al. 2017

Epidemiologic Reviews

151

122

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Transgender people comprise a diverse group of individuals whose gender identity or expression differs from that originally assigned to them at birth. Some, but not all, transgender people elect to undergo medical gender affirmation, which may include therapy with cross-sex hormones and/or surgical change of the genitalia and other sex characteristics. As cross-sex hormones administered for the purposes of gender affirmation may be delivered at high doses and over a period of decades, the carcinogenicity of hormonal therapy in transgender people is an area of considerable concern. In addition, concerns about cancer risk in transgender patients have been linked to sexually transmitted infections, increased exposure to well-known risk factors such as smoking and alcohol use, and the lack of adequate access to screening. Several publications have identified cancer as an important priority in transgender health research and called for large-scale studies. The goals of this article are to summarize the evidence on factors that may differentially affect cancer risk in transgender people, assess the relevant cancer surveillance and epidemiologic data available to date, and offer an overview of possible methodological considerations for future studies investigating cancer incidence and mortality in this population.

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“…In transmen, published case reports describe cancers of the breast, ovaries, cervix, vagina, and endometrium (17,18,34,35,44,45,(64)(65)(66)(67)(68).…”

Section: Possible Effects Of Cross-sex Hormonesmentioning

confidence: 99%

Section: Possible Effects Of Cross-sex Hormonesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cancer in Transgender People: Evidence and Methodological Considerations

Braun

Nash

Tangpricha

et al. 2017

Epidemiologic Reviews

151

122

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show abstract

“…Firstly, it is well known that oral contraceptives, which suppress ovarian testosterone production (Gaspard et al 1983, Murphy et al 1990, Greer et al 2005, protect against ovarian cancer. Secondly, there have been a number of case reports of ovarian cancer in female-to-male transsexuals who have undergone testosterone supplementation (Hage et al 2000, Dizon et al 2006, although the true incidence of the disease in this population is not yet known. Other potentially supportive evidence has come from a small number of population-based casecontrol studies.…”

Section: M Olsen Et Al: Ovarian Cancer and The 'Androgens Hypothesis'mentioning

confidence: 99%

Epithelial ovarian cancer: testing the 'androgens hypothesis'

Olsen

Green²,

Nagle³

et al. 2008

Endocrine Related Cancer

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In 1998, Risch proposed a hypothesis for the pathogenesis of ovarian cancer relating to the role of androgens in stimulating epithelial cell proliferation. Although this hypothesis has been widely discussed, direct evidence to support it is scant. To address this issue, we have conducted a detailed analysis of factors possibly associated with high circulating levels of androgens, including polycystic ovary syndrome (PCOS), hirsutism and acne (all clinically associated with hyperandrogenism) using the data collected in an Australia-wide, population-based case-control study. Cases aged 18-79 years with a new diagnosis of invasive epithelial ovarian cancer (nZ1276) or borderline malignant tumour (nZ315) were identified through a network of clinics and cancer registries throughout Australia. Controls (nZ1508) were selected from the National Electoral Roll. Women self-reported a history of PCOS, acne, hirsutism and also use of testosterone supplements or the androgenic medication Danazol. We found no evidence that a history of PCOS, acne or hirsutism was associated with ovarian cancer overall, or with specific subtypes, with the exception of serous borderline tumours that were positively associated with a history of PCOS (OR 2.6; 95% CI 1.0-6.1). Women who had ever used testosterone supplements had an increased risk of ovarian cancer (OR 3.7; 95% CI 1.1-12.0); however, use of the androgenic medication Danazol did not increase risk (OR 1.0; 95% CI 0.4-2.9). Overall, our results do not support the hypothesis that androgen-related disorders increase the risk of ovarian cancer.

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“…Three cases of ovarian carcinoma in testosterone-treated FTM, diagnosed before they underwent surgery, have been reported (32,33).…”

Section: Ovarian Cancermentioning

confidence: 99%

Hormone-related tumors in transsexuals receiving treatment with cross-sex hormones

Mueller

Gooren

2008

European Journal of Endocrinology

113

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Objective: To assess the risk of development of hormone-related tumors in transsexuals receiving treatment with cross-sex hormones. Design: Description of cases of transsexuals who have developed a hormone-related malignancy observed in their own clinic or reported in the literature. Recommendations for early diagnosis and prevention are presented. Methods: Review of the literature in PubMed. Results: In male-to-female transsexuals receiving estrogen administration, lactotroph adenomas, breast cancer, and prostate cancer have been reported. In female-to-male transsexuals receiving treatment with testosterone, a single case of breast carcinoma and several cases of ovarian cancer have been reported. So far endometrial cancer has not been encountered though it remains a potential malignant development. Conclusions: There are so far only a few cases of hormone-related cancer in transsexuals. There may be an underreporting. The probability of a hormone-related tumor increases with the duration of exposure to cross-sex hormones and the aging of the population of transsexuals.

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Ovarian Cancer Associated with Testosterone Supplementation in a Female-to-Male Transsexual Patient

Cited by 83 publications

References 9 publications

Cancer in Transgender People: Evidence and Methodological Considerations

Cancer in Transgender People: Evidence and Methodological Considerations

Epithelial ovarian cancer: testing the 'androgens hypothesis'

Hormone-related tumors in transsexuals receiving treatment with cross-sex hormones

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