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Cancer Facts for Gay and Bisexual Men

Protect yourself and the people you care about.

Recognizing barriers. Saving lives.

The most common types of cancer among men in the US are prostate, lung, colon, and skin cancers. Anal and testicular cancers are also found in men. There are things you can do to help reduce your risk for these cancers or find them early – when they are small, have not spread, and are easier to treat.

But gay and bisexual men face a number of barriers to getting the routine health care and cancer screening tests they need. Some of the reasons for this include:

  • Low rates of health insurance: Many health insurance policies do not cover unmarried partners. This makes it harder for many gay and bisexual men to get quality health care. Many states now offer family health insurance plans that may help you get coverage in other ways.
  • Fear of discrimination: Many men don’t tell their doctors about their sexual orientation, because they don’t want discrimination to affect the quality of health care they receive. This can make it harder to have a comfortable relationship with a provider. A lesbian, gay, bisexual, and transgender/transsexual (LGBT) community center or group may be able to refer you to LGBT-friendly health care professionals.
  • Negative experiences with health care professionals: Fear of having a negative experience with a health care professional can lead some men to delay or avoid medical care, especially routine care such as early detection tests. Missing routine cancer screenings can lead to cancer being diagnosed at a later stage, when it’s harder to treat. Today, there are many LGBT-friendly health professionals. Don’t give up – find the respectful care you deserve!

The American Cancer Society can help you learn more about the cancers that men are most at risk for, as well as how to find these cancers early. All men can do things to help reduce their cancer risk and stay well.

Prostate cancer

Who is at risk?

Most prostate cancer occurs in men older than 50. African American men are more likely to develop prostate cancer than men of other races. Having one or more close relatives with prostate cancer also increases a man’s risk, as does eating a lot of red meat or high-fat dairy products.

What you can do

Prostate cancer can often be found in its early stages by having a prostate-specific antigen (PSA) blood test with or without a rectal exam. But many prostate cancers grow slowly and will never cause harm. The tests used today can find prostate cancer, but many times they can’t tell if the cancer is truly dangerous. Finding and treating slow-growing cancers that are not dangerous to your health can lead to treatment side effects that you might not want, such as problems with your sex life or trouble controlling your urine.

Talk to a doctor about prostate cancer screening tests every year starting when you are 50. Talk about the benefits and limitations of testing so you can make an informed decision about whether to be tested. If you are African American or have a close relative who has/had prostate cancer when they were younger than 65, you should start having these discussions at age 45.

Lung cancer

Who is at risk?

People who smoke are at greatest risk for lung cancer, and current evidence suggests that gay and bisexual men are much more likely to smoke than heterosexual men.1 Smoking is responsible for 87% of all lung cancer deaths, and is linked to many other cancers, too. It’s also responsible for other tobacco-related diseases such as heart disease, bronchitis, stroke, and emphysema. Research further suggests that HIV-positive smokers do not live as long as their non-smoking HIV-positive peers.2

Smoking is common in bars and clubs where gay and bisexual men may socialize. Even if you don’t smoke, this exposure increases your risk of lung cancer and other diseases caused by secondhand smoke.

What you can do

Lung cancer is one of the few cancers that can often be prevented simply by not smoking. If you don’t smoke, don’t start. You can also reduce your exposure to secondhand smoke by seeking smoke-free places. If you or a loved one smokes, talk to a health care professional about quitting, or call 1-800-227-2345 to find out how we can help improve your chances of quitting for good.

Certain men at high risk for lung cancer may want to talk to a doctor about whether getting a low-dose CT scan to screen for early lung cancer is right for them. Screening may benefit adults who are active or former smokers between the ages of 55 and 74 who have no signs of lung cancer and who have a 30 pack-year smoking history. (A pack-year is 1 pack of cigarettes per day per year. One pack per day for 30 years or 2 packs per day for 15 years would both be 30 pack-years.) You should discuss the benefits, limitations, and risks of lung cancer screening with a doctor before testing is done.

Colon cancer

Who is at risk?

Most colorectal cancers (commonly known as colon cancer) are found in people age 50 and older. Those with a personal or family history of the disease, and people who have polyps in the colon or rectum, or inflammatory bowel disease are at greater risk. A diet high in red and processed meats, alcohol use, being overweight, smoking, and being inactive also increase risk.

What you can do

Colon cancer almost always starts with a polyp – a small growth on the lining of the colon or rectum. Testing can save lives by finding polyps before they become cancer. If pre-cancerous polyps are removed, colon cancer can be prevented. A diet that includes plenty of fruits and vegetables, whole grains, and limits red or processed meat may also help lower risk.

The American Cancer Society recommends all people at average risk for colorectal cancer have 1 of the following tests starting at age 50:

Tests that find polyps and cancer:

  • Flexible sigmoidoscopy every 5 years
  • Double-contrast barium enema every 5 years
  • Colonoscopy every 10 years
  • A CT colonography every 5 years

Tests that find mainly cancer:

  • Fecal occult blood test (FOBT) or fecal immunochemical test (FIT), also known as a stool blood test, every year
  • Stool DNA test (sDNA), interval uncertain (this test is currently not available)

Tests that have the best chance of finding both polyps and cancer should be your first choice when possible. Talk with a doctor or nurse to find out which tests are right for you.

Skin cancer

Who is at risk?

People with fair skin, especially those with blond or red hair, are at greater risk for skin cancer than people with darker coloring. But anyone who spends a lot of time in the sun is at risk. People who have had close family members with melanoma or who had severe sunburns before the age of 18 are at higher risk for skin cancer.

What you can do

Most skin cancers can be prevented by staying out of the midday sun for long periods of time. Here are some other things you can do to help prevent skin cancer:

  • Protect your skin by wearing hats with wide brims, long-sleeved shirts, and sunglasses when you are outside.
  • Use sunscreen with an SPF of 30 or higher on all exposed skin. Sunscreens should block both UVA and UVB sun rays, and should be applied at least 15 to 30 minutes before going outside. Be sure to wear sunscreen on cloudy or overcast days too because UV rays travel through clouds.
  • Avoid other sources of UV light, like tanning beds and sunlamps. These are dangerous and can damage your skin.
  • Know your skin, and report any skin changes to a doctor or nurse. Have a skin exam done during your regular health check-ups.

Anal cancer

Who is at risk?

Infection with the human papilloma virus (HPV) increases the risk of anal cancer. HPV risk is increased by having anal sex and having many sex partners. Smoking also increases your risk for this cancer. Another risk factor is a weak immune system because of HIV infection or other factors.

What you can do

You can reduce your risk of anal cancer by not having many sex partners and using condoms. Quitting smoking will also lower your risk of anal cancer and many other cancers.

Condoms will not always protect against HPV, because HPV can be passed by skin-to-skin contact with any area of the body, such as skin of the genital or anal area not covered by the condom. Still, it’s very important to use condoms to protect against HIV and other diseases that are passed through body fluids.

Be aware of any rectal symptoms, and report them to a health care professional right away. A rectal exam will find some cases of anal cancer early. Some experts recommend screening with an anal Pap test for those who might be at high risk for anal cancer. This test has not been studied enough to know how often it should be done, or if it reduces the risk of anal cancer. But you may want to talk to a doctor to see if this test might be right for you.

Testicular cancer

Who is at risk?

Most testicular cancers occur in men between the ages of 20 and 34. White men have a higher risk than men of other races. The main risk factor for testicular cancer is a condition called cryptorchidism, or undescended testicle(s). A family history of testicular cancer also increases a man’s risk. Some evidence suggests that men with HIV, especially those with AIDS, are at greater risk.

What you can do

Most testicular cancers start with a lump on a testicle that’s often painless. Men may also notice swelling, or have a heaviness or achiness in the lower abdomen (belly) or scrotum. Some doctors recommend monthly testicular self-exams after puberty. This helps you know what’s normal for you so you can notice any changes that may take place. See a health care professional right away if you notice changes or have any signs or symptoms of testicular cancer.

Finding cancer early

We may not know enough today to help prevent all cancers. But for many cancers, early detection – finding cancer while it’s small, before you have symptoms, and before it has spread – gives you the best chance of getting treatment that works.

All men should see a doctor or nurse on a regular basis, learn about the benefits and limitations of testing, and get the cancer screenings that are right for them. They should also try to make healthy lifestyle choices that help reduce cancer risk. Knowing about these most common cancers and what you can do to reduce your risk of cancer or find it early may save your life or the life of someone you love.

To learn more about what you can do to stay well and help reduce your cancer risk, call us at 1-800-227-2345.

Notes

1 Boehmer U, Miao X, Linkletter C, Clark MA. Adult health behaviors over the life course by sexual orientation. Am J Public Health. 2012;102(2):292-300.

2 Petrosillo N, Cicalini S. Smoking and HIV: time for a change? BMC Med. 2013;11:16.

Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. 2011; Institute of Medicine.

Take control of your health, and reduce your cancer risk.

  • Stay away from tobacco.
  • Get to and stay at a healthy weight.
  • Get moving with regular physical activity.
  • Eat healthy with plenty of fruits and vegetables.
  • Limit how much alcohol you drink to no more than 2 drinks a day.
  • Protect your skin from the sun.
  • Know yourself, your family history, and your risks.
  • Have regular check-ups and cancer screening tests.

The most common cancers in men are prostate, lung, colon, and skin cancers. Anal and testicular cancers are also found in men.

The American Cancer Society can help you learn more about these cancers, how to find them early, and how to help reduce your risk.

Call us anytime, day or night, at 1-800-227-2345.

Last Medical Review: 05/31/2013
Last Revised: 05/31/2013