Cancer Facts for Gay and Bisexual Men

Many gay and bisexual men avoid going to the doctor or sharing their sexual orientation and history with their health care provider to avoid being discriminated against.  

Many health care providers report not having education on the unique risk factors and recommended cancer screening tests for lesbian, gay, bisexual, transgender, queer/questioning, intersex, or asexual (LGBTQIA+) people.

Gay and bisexual men are more likely to have trouble paying for medical insurance and medical bills than non-LGBTQIA+ adults. This can make it harder for many gay and bisexual men to get high quality health care.

The American Cancer Society recommends that men make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the potential risks and benefits of prostate cancer screening.

This discussion about screening should take place at:

• Age 50 for men at average risk of prostate cancer who are expected to live at least 10 more years
• Age 45 for men at high risk of prostate cancer, including all men of African ancestry and any man with a father or brother diagnosed with prostate cancer before age 65
• Age 40 for men at even higher risk, including any men with more than one first-degree relative (father or brother) who were diagnosed with prostate cancer before age 65 and men who carry any BRCA gene mutations

If you decide to get screened for prostate cancer

Men who decide to get screened should be tested with the prostate-specific antigen (PSA) blood test. A digital rectal exam (DRE) might also be done as a part of screening. How often you are tested will depend on your PSA level, health, family history, and preferences.

Regular colorectal cancer screening helps prevent colorectal cancer or find it early, when treatment is more likely to be successful.

Most colorectal cancers start with a polyp – a small growth in the colon or rectum. Certain screening tests can remove polyps before they turn into cancer.

The American Cancer Society recommends the following for people at average risk for colorectal cancer:

• Everyone should start regular screening at age 45.
• People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through age 75.
• For people ages 76 to 85, the decision to be screened should be based on a person’s preferences, life expectancy, health, and screening history.
• People over age 85 should no longer get colorectal cancer screening.

Screening tests for colorectal cancer

Screening can be done either with a stool-based test, which looks for signs of cancer in a person’s stool, or a visual exam, which is an exam that looks at the colon and rectum.

Stool-based tests

Options include:

• Fecal immunochemical test (FIT)* every year
• Guaiac-based fecal occult blood test (gFOBT)* every year
• Stool DNA test with fecal immunochemical testing (MT-sDNA or sDNA-FIT or FIT-DNA) every 3 years*

Visual (structural) exams of the colon and rectum

Options include:

• Colonoscopy every 10 years
• CT colonography (virtual colonoscopy)* every 5 years
• Sigmoidoscopy* every 5 years

*If a person gets screened with a test other than colonoscopy, any abnormal test result should be followed up with colonoscopy.

If you’re at high risk

If you're at high risk of colorectal cancer you might need to start screening before age 45, be screened more often, or get specific tests. You might be at higher risk if you have:

• A personal history of polyps, colorectal cancer, inflammatory bowel disease, or radiation to your abdomen (belly) or pelvic area 
• A family history of polyps, colorectal cancer, or a hereditary colorectal cancer syndrome

There are some differences between these tests to consider, but the most important thing is to get screened, no matter which test you choose.

Talk to a health care provider about which tests might be good options for you and to your insurance provider about your coverage. If you don't have insurance or can't afford cancer screening, find free and low-cost screening options.

The American Cancer Society recommends yearly lung cancer screening with a low-dose CT (LDCT) scan for people who:

• Are ages 50 to 80 years and smoke or used to smoke

AND

• Have at least a 20 pack-year history of smoking

A pack-year is equal to smoking 1 pack of cigarettes per day for a year. For example, a person could have a 20 pack-year history by smoking 1 pack a day for 20 years or by smoking 2 packs a day for 10 years.

Before deciding to get screened, people should talk to their health care provider about the purpose of screening, how it's done, the benefits, limitations, and possible harms of screening. People who still smoke should be counseled about quitting and offered resources to help them quit.

Smoking tobacco is the leading cause of cancer. If you don’t smoke, don’t start.

If you smoke, takes steps to quit using tobacco. You can also call the American Cancer Society at 1-800-227-2345 or visit Empowered to Quit for help quitting.

Other ways you can help lower your risk:

• Avoid radon exposure.
• Stay away from secondhand smoke.
• Avoid or limit exposure to cancer-causing chemicals at home or in your workplace.

Practicing sun safety is one of the most important things you can do to lower your risk of skin cancer:

• Seek shade and limit time in the sun, especially between 10 a.m. and 4 p.m. when the sun's rays are strongest.
• Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30 on exposed skin all year round. Reapply sunscreen every 2 hours or after swimming or sweating, even if it's waterproof.
• Wear protective clothing, sunglasses that have UV protection, and a hat.
• Avoid tanning beds and sun lamps.

The best way to catch skin cancer early is to check your skin for changes. Many health care providers suggest checking your skin about once a month.

• Know what the moles and spots on your skin look like and report any changes to a health care provider right away.
• Ask about having a skin exam done during your regular health checkups.

The American Cancer Society recommends all children get the HPV vaccine between the of ages 9 and 12, when the vaccine works best. But teens and young adults should still get the vaccine through age 26.

Vaccination at the recommended ages will help prevent more cancers than vaccination at older ages. If you're between the ages of 27 to 45, talk to your doctor to find out if HPV vaccination might benefit you.

While there aren't any widely recommended screening tests for anal cancer, some experts suggest screening with a digital rectal exam (DRE) and an anal Pap test for those who might be at high risk for anal cancer.

Screening has not been studied enough to know how often it should be done, or if it helps reduce the risk of anal cancer. But you might want to talk to a provider about whether it might be right for you.

There aren't any recommended screening tests for testicular cancer but the American Cancer Society recommends that men learn the signs and symptoms of testicular cancer. Some doctors suggest all men check their testicles once a month after puberty.

Signs and symptoms of testicular cancer can include:

• A lump, swelling, or pain in one testicle
• Heaviness or aching in the lower abdomen (belly) or scrotum
• Breast growth or soreness

If you notice any changes in the way your testicles look or feel, talk to a doctor right away.