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Study Finds Higher Reported Instances of Cancer in Gay Men

Results of a study based around the California Health Interview survey have been published in the journal Cancer and reveal an inconclusive set of statistics about disparities in reported cancer rates in gay and straight men, Reuters reports:

Nlcn Out of 51,000 men, about 3,700 said they had been diagnosed with cancer as an adult. While just over 8 percent of gay men reported a history of cancer, that figure was only 5 percent in straight men. The disparity could not be attributed to differences in race, age, or income between gay and straight men.

About 7,300 out of 71,000 women in the study had been diagnosed with cancer, but overall cancer rates did not differ among lesbian, bisexual, and straight women.

What's causing the disparity is unclear:

Ulrike Boehmer, the study's lead author from the Boston University School of Public Health, said higher rates of human immunodeficiency virus (HIV) may be related to the increased risk of cancer in gay men, but the study couldn't address that question specifically.

[Liz] Margolies [executive director of The National LGBT Cancer Network] thinks there is more going on. "Gay men as a group have a bunch of risk factors for cancer," she said.

For instance, gay men and lesbian women are more likely to smoke and abuse alcohol than straight men and women. They're also more likely to avoid going to see their doctor for routine physicals or cancer screening, Margolies added - since healthcare providers may not all be tolerant and accepting of their identity.

The takeaway? "Gay, lesbian and bisexual people need more attention from the healthcare community, specifically when it comes to their cancer risks."

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Comments

  1. Somehow when seeing the headline I knew it would come down to that last paragraph in the quote.

    Posted by: ravewulf | May 9, 2011 9:31:12 AM


  2. I think this is a silly survey. For one thing, many men aren't going to reveal their sexual orientation to a cancer researcher. Most men won't reveal their sexual orientation to a sex researcher let alone a cancer researcher.

    Moreover, where do bisexual men fit in all this? If Kinsey is to believed, most men are bisexually oriented yet this cancer risk study seems to confine male sexuality to the gay and straight poles of the sexuality spectrum.

    Overall, it just seems that this is yet another flawed survey that relies on the pity-me-I'm-gay notion in order to get publicity.

    Posted by: brian | May 9, 2011 9:37:49 AM


  3. HIV positive persons are much more likely to develop cancers. Without examining HIV status the results of this study are completely suspect.

    Posted by: qjersey | May 9, 2011 10:09:03 AM


  4. So I thought this was going to be a story primarily about HPV and anal cancer and I'm shocked that the article doesn't seem to even mention those factors! The other risk factors mentioned are points well-made, however.

    Posted by: redball | May 9, 2011 10:22:36 AM


  5. Entrenched homophobia among health professionals accounts for why gay men and lesbians are less likely to receive proper medical care. Even in major metropolitan areas, it's difficult to find gay or gay friendly physicians.

    In the 1980s, I gathered research data for an epidemiological research study on anal cancer for a West Coast medical school. A substantial number of patients in the study were gay. It took the principal investigator over 10 years to even get the study accepted for publication in a medical journal.

    Anal cancer is easily detected and treated, if caught early enough. But how many gays feel comfortable discussing such matters with their physician or asking for a referral to a proctologist?

    What's needed is a registry of gay and gay friendly physicians for major metropolitan areas, so that gays and lesbians can get proper care and treatment free of homophobic bias. Especially among younger gays, who like their straight counterparts believe they'll live forever, establishing contact with a reliable, trustworthy medical professional is essential to good health and care.

    Posted by: Jack | May 9, 2011 10:23:21 AM


  6. The key is your body's immune system. Many things adversely affect the immune system, obviously substance abuse, but also stress. Stress does the #1 damage to a body's immune system. People who live with a lot of stress are also more likely to develop autoimmune diseases [including mundane stuff like eczema and allergies], and cancers.

    Also, an obviously higher prevelence of HIV and AIDS adversely affects gay men.

    I would agree there're complex issues regarding heathcare for many gay people [that 'str8s' don't deal with to such a degree] that prevent many from getting regular and timely heathcare.

    Finally, I question how they can get really accurate statistics. Most people, when asked what their sexuality is for a survey, even an alleged 'aonymous' survey, won't tell or outright lie. Sexuality is a hot-button issue most people prefer to keep private, even in 2011.

    Posted by: ratbastard | May 9, 2011 10:29:28 AM


  7. Actually, the issue of men who have sex with men lying about their sexuality over the phone only reinforces the findings. This is called misclassification bias and it means that some MSM may have been incorrectly classified as straight. This means that the "straight" group in the study actually contains some gay and bi men who would raise the estimated cancer rate in the "straight" group. But compared to this inflated cancer rate in the straight group, the gay group STILL had a higher cancer rate.

    Which means the results are striking indeed.

    Misclassification bias will shrink the estimated difference between two groups, so if there is misclassification bias that means that the TRUE difference between the groups is actually larger than what we observe.

    Posted by: redball | May 9, 2011 10:45:00 AM


  8. @Jack: I'm SO with you. Every major (and minor) city in the country should have a registry of gay-friendly and gay-informed physicians.

    I mean, I don't end up going to the doc all that much or anything, but whenever I move, I have to rely on friends for referrals for a physician for basic checkups and such. Cuz there are TONS of IGNORANT docs. And who wants to deal with that already.

    Also, I'm honestly turned off by all the AIDs-focused docs being presented as the only gay-friendly ones. I know gay men face the risk of AIDs (as do others, frankly). But I just have never felt GOOD about patronizing a doc focused on AIDs patients. I guess I just feel like those guys are SO different from me in terms of health concerns--also another reason QJersey's point about not accounting for that makes the results NOT credible.

    Just my two-cents.

    (And, yeah, I'll prolly be attacked here for not being AIDs-friendly, but I'm bein straight-up here already, ok. I'm FAR more interested in gay men's health without the complications of AIDs. And in living a healthy and fulfilling life, AVOIDING that and other viruses, and staying proactive preventatively, etc.)

    Posted by: just_a_guy | May 9, 2011 11:30:53 AM


  9. I am surprised there was no discussion of HPV-related cancer in the article. My husband is fighting anal cancer (which he thought was hemorrhoids in its initial manifestation), and we've learned that incidence of HPV-related anal, oral and penile cancers are all on the rise in men, particularly gay men, and that HPV is becoming more and more of a health problem.

    So I definitely agree with the earlier commenter that we need to be aware and proactive in ensuring we are checked for these cancers when they are most treatable. No one wants to go thru what my husband is currently going thru!

    Posted by: Jim H | May 9, 2011 11:32:17 AM


  10. Good advice, Jim H. Oh, and in my early comment, note that I prolly should've used "HIV" in each spot I put "AIDs."

    Do we even KNOW that gay guys face more HPV than straights, when you take out the HIV/AIDs related statistics? I think these sort of things need to be broken down to be credible. Of course, getting ourselves screened by an in-the-know doc seems wise regardless...

    Posted by: just_a_guy | May 9, 2011 12:02:55 PM


  11. The BBC article on the story asks some more interesting questions:
    http://www.bbc.co.uk/news/health-13295300

    For example, due to the way the survey was designed it's possible that the results mean that gay men are more likely to _survive_ cancer.

    To me it just looks like researchers angling for more funding.

    Posted by: Kevin | May 9, 2011 12:05:03 PM


  12. As a queer Canadian, I'd like to see a contrast done involving gay men in CANADA as opposed to gay men in the USA, and see if the factors listed above (which are rather relevant, as most of you understand) are at all different in a country with universal healthcare and a much more progressive and protective culture for LGBT people.

    Posted by: Little Kiwi | May 9, 2011 12:15:32 PM


  13. Just_a_guy, I used to try to stay informed on this stuff. The research seemed to say that persistent HPV infection is more common among gay men than straight men. From what I've read, sexually active women and gay men tend to have higher infection rates b/c, to be unPC about it, penises are covered in HPV so when you are penetrated by one you are exposed (even if you're using a condom!). However, HPV infections often clear on their own, so we don't have to worry those ones. It's the infections that stick around (persistent infections) that might ultimately cause cancer, but then there are several strains of HPV and only some of them are cancerous. I think there might have also been something about skin on the cervix and anus being less likely to clear HPV infection than skin on the penis. Some reputable public health or medical websites would have more info....

    Posted by: redball | May 9, 2011 12:21:52 PM


  14. @Little Kiwi,

    I know a guy who is on what we call Medicaid. He get's essentially free healthcare. Free office visits [no co=pay], free drug prescriptions, or at most a very nominal co-pay [3-5 dollars]. He even get's free rudimentry dental.

    In addition to Medicaid, the U.S. has Medicare for senior citizens [google these two programs, too involved to explain here].

    The U.S. also operates a massive, seperate government-run healthcare system for veterans called V.A. hospitals.

    Anyone in the U.S. with low income qualifies for Medicaid. Many elderly qualify for Medicaid and Medicare both. 'poor' folks also qualify for a multitude of social service programs from food stamps, housing vouchers/subsidies, child care, SSI [for disabled, mental and physical...usually minimun $1200./month, which you can collect concurrently with housing subsidies, energy subsides, food subsidies, heathcare, etc.,]

    In my state everyone by law must have health insurance, and the state has set up a system whereas if you don't qualify for 'free' healthcare, you can buy your own health insurance at reasonable bulk rates from private insurers [and government-sponsored]. Factoring the cost of taxes, fees, etc., these health insurance plans at the basic level are comparable to Health Canada, and many are better than Health Canada. None of them are worse than Health Canada.

    I realize to someone like you [who probably get their info from flawed media reports] the U.S. system is very complicated and [it is], but it's not nearly as 'bad' as made out to be. And since I'm familiar with the Canadian single payer heathcare system [and how any additional private heathcare is fought tooth and nail by some 'advocates' in Canada], I know it's a seriously flawed 'system' and absolutely not the best 'system' in the world.

    In reality, the U.S. is pretty much just as 'socialist' as Canada, in some respects even more so. Canada is not nearly 'progressive' as some Canadians [and non-Canadian leftist] make it out to be.

    As for gay rights, the U.S. IS NOT a 'hell=hole' by any stretech of the imagination. In fact, MANY foreign gays would love to live here. And my state has had gay MARRIAGE for 7 years now.

    Posted by: ratbastard | May 9, 2011 12:41:56 PM


  15. Thank you, ratbastard, for proving me right.

    I've been living in the USA for three years now. The culture shock was greater than I'd ever anticipated.

    How wonderful that your state has had gay marriage for 7 whole years. Too bad that since Marriage Equality is not a federal mandate that LGBT foreigners cannot legally marry their American spouses though, eh?

    I was born and raised in Canada. I spent two years living in the UK. And now I've been living in the USA for three years.

    So I can utterly see where you're coming from with your statements, and how deeply and sadly incorrect you are. I know you love your country, and your comments are borne of some Patriotism, but you just proved me right.

    So thanks.

    But keep telling yourself what you need to tell yourself. It won't help your country, that's for sure. But if it helps you sleep at night..well...then...uh...great.

    Posted by: Little Kiwi | May 9, 2011 1:00:19 PM


  16. It is not true that anyone who is low income in the United States qualifies for Medicaid. I applied in Illinois when I had no job and no health insurance and they laughed at me and said I could only get it if I had children or was disabled. It varies from state to state.

    Posted by: Brad | May 9, 2011 1:21:44 PM


  17. Oh come on, what's causing this is not unclear. HIV aside (Sidebar: how the hell does the CHIS questionnaire not have a question on HIV status? They ask adolescents about HIV testing, but that's it. Helpful.), and acknowledging that yes, the LGBT population as a whole smokes, drinks and uses illicit substances at a higher rate than the general population (largely to cope with stress, although let's not just ignore the very large effects all of those toxic substances have), there are other reasons.

    While cancer rates due to HIV/AIDS aren't as high as they used to be due to ARVs, opportunistic infections of cytomegalovirus, Epstein-Barr virus, herpes viruses, HPV etc. still occur and can cause cancer.

    Also, we are exposed to more cumulative stress over our lives. Cumulative stress increases risk of cancer. Ask any epidemiologist, those effects are large.

    Gay men are more susceptible to the effects of carcinogenic viruses like HPV-16 and HPV-18 (i.e. their ability to cause anal cancer). Yes, we know MSM (men who have sex with men) have higher rates of HPV-caused cancers than non-MSM and the inequity of female-only vaccination isn't helping any there, the virus spreads mostly in the teenage years, so vaccinating MSM only once they're older, have accepted that they're having sex with men or likely to have sex with men, and are prepared to ask their health care provider for a vaccine.

    Substances, HIV/AIDS opportunistic infections, carcinogenic viruses in general, stress: et voila. We have a difference in cancer rates.

    Posted by: Scott | May 9, 2011 1:45:17 PM


  18. WHY THE HELL DO GAY MEN AND WOMEN SMOKE ANYWAY?! Don't you realize who you are supporting? The cigarette companies are mostly conservative and Republican-orientated! And the smoke gets in your hair and clothes and lungs and makes you smell like an ash tray and it RUINS YOUR HEALTH. And the secondhand smoke hurts the people who love you enough to want to be around you even while you're hurting them with your habit. So you're supporting bigots and doing yourself and others harm at the same time! That's not very attractive at all. :|

    Posted by: ophu | May 9, 2011 2:44:14 PM


  19. @Brad,

    If you had NO income, or VERY LOW income, than you absolutely qualified for Medicaid [Illinois has it's own name for it?] If you had other income and/or were collecting unemployment, than you probably were means tested and considered to have too much income. If you were collecting unemployment than you also had COBRA. Most peoiple of course can't afford COBRA premiums, I understand that. My state, Massachusetts, will pay 80% of an unemployed persons COBRA premiums. And , if you have no income coming in or very little, you absolutely qualify for MassHealth [i.e. Medicaid] and pay no premiums, little or no co-pays, little of no co-pays for prescription drugs. Massachusetts also has pool private insurance plans available for people who can't get health insurance through their job [rare, at least in MA]. Premiums are comparable to what you'd pay if your employer were subsidizing. I understand states differ, but Medicaid is for 'poor' people.

    Posted by: ratbastard | May 9, 2011 6:46:30 PM


  20. @LITTLE KIWI,

    You proved NOTHING except you are the pompous, arrogant one, not me. Again, DID NOT prove your point, just made snide comments about me.

    I KNOW Health Canada s*cks, Kiwi. And Canadians pay through the nose for a system and plan that's often inferior to what most Americans get through their employer, or even through Medicaid and Medicare. Taxes and government fees [and regulation that protects a few Canadian and 'Crown' Corporation monopolies from competition] are awful across Canada [some provinces much worse than others]. So your 'free' healthcare IS NOT 'free', and would be roughly the equivilent of a basic American HMO.

    The one area of all this that I think really differentiates the U.S. and Canada is means testing. In the U.S. my impression is people are more subjected to means testing for government social services like health insurance, etc., than in Canada. In the U.S., you really have to prove you're 'poor' to get the freebies, but there are a lot of freebies.

    Posted by: ratbastard | May 9, 2011 7:05:28 PM


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