Table 2.
Associations between transgender gender identity with stage at cancer diagnosis and receipt of cancer treatment by cancer site among patients in the National Cancer Database, 2003-2016
| Cancer site and stage at diagnosis | No. transgender cases | OR (95% CI)a | Received any cancer treatmentb | No. transgender cases | OR (95% CI)c |
|---|---|---|---|---|---|
| Anus, anal canal, and anorectum | |||||
| I and II | 11 | 1.00 (Referent) | No | <10e | 1.00 (Referent) |
| III and IV | 14 | 1.61 (0.73 to 3.56) | Yes | 26 | 0.62 (0.14 to 2.69) |
| Breast | |||||
| 0, I, and II | 24 | 1.00 (Referent) | No | <10e | 1.00 (Referent) |
| III and IV | 11 | 1.80 (0.87 to 3.70) | Yes | 34 | 0.97 (0.13 to 7.24) |
| Kidney and renal pelvis | |||||
| I and II | 19 | 1.00 (Referent) | No | <10e | 1.00 (Referent) |
| III and IV | <10e | 0.65 (0.24 to 1.77) | Yes | 17 | 0.19 (0.08 to 0.47) |
| Liver and intrahepatic bile duct | |||||
| I and II | 14 | 1.00 (Referent) | No | 13 | 1.00 (Referent) |
| III and IV | <10e | 0.76 (0.33 to 1.77) | Yes | 13 | 0.65 (0.30 to 1.44) |
| Lung and bronchus | |||||
| I and II | 12 | 1.00 (Referent) | No | 20 | 1.00 (Referent) |
| III and IV | 63 | 1.76 (0.95 to 3.28) | Yes | 59 | 0.74 (0.47 to 1.24) |
| Melanoma of the skin | |||||
| I and II | 11 | 1.00 (Referent) | No | <10e | 1.00 (Referent) |
| III and IV | <10e | 2.11 (0.77 to 5.82) | Yes | 15 | 0.34 (0.07 to 1.76) |
| Non-Hodgkin lymphoma | |||||
| I and II | 15 | 1.00 (Referent) | No | 12 | 1.00 (Referent) |
| III and IV | 29 | 1.59 (0.85 to 2.97) | Yes | 35 | 0.87 (0.44 to 1.69) |
| Pancreas | |||||
| I and II | <10e | 1.00 (Referent) | No | <10e | 1.00 (Referent) |
| III and IV | 10 | 1.12 (0.41 to 3.08) | Yes | <10e | 0.33 (0.11 to 0.95) |
| Prostated | |||||
| I and II | 25 | 1.00 (Referent) | No | <10e | 1.00 (Referent) |
| III and IV | 10 | 1.69 (0.81 to 3.55) | Yes | 30 | 0.82 (0.34 to 2.00) |
| Rectum | |||||
| I and II | 12 | 1.00 (Referent) | No | 0 | 1.00 (Referent) |
| III and IV | 11 | 0.80 (0.35 to 1.82) | Yes | 26 | —f |
| Urinary bladder | |||||
| 0, I, and II | <10e | 1.00 (Referent) | No | 0 | 1.00 (Referent) |
| III and IV | <10e | 2.11 (0.76 to 5.89) | Yes | 15 | —f |
aOR calculated with multivariable logistic regression for the association of being transgender (using cisgender as reference group) with stages III and IV vs stage 0 (if applicable), I, and II, adjusted for age at diagnosis (18-44, 45-54, 55-64, or 65 years and older), race and ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, or other), and year of diagnosis (2004-2006, 2007-2010, or 2011-2014). AJCC = American Joint Committee on Cancer; CI = confidence interval; OR = odds ratio.
bCancer treatment is defined as chemotherapy, surgery, and radiotherapy for all sites except lymphoma. Treatment for lymphoma is defined as chemotherapy and radiotherapy.
cOR calculated with multivariable logistic regression for the association of being transgender (using cisgender as reference group) with cancer treatment, adjusted for age at diagnosis (18-44, 45-54, 55-64, or 65 years and older), race and ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, or other), year of diagnosis (2004-2006, 2007-2010, or 2011-2014), and AJCC stage (0-II, III/IV, or unknown).
dSex-specific site uses cismen only as reference group.
eCells with more than 0 but fewer than 10 individuals are suppressed.
f“—” indicates that the cell size was too small to calculate the OR.