Cancer Facts for Gay and Bisexual Men

Protect yourself and the people you care about.

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. 

Recognizing barriers

Studies have found that gay and bisexual men get less routine health care than other men.1 They face a number of barriers to getting the health care and cancer screening tests they need, including: 

  • 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.1
  • Fear of discrimination: Many men don’t tell their health care providers about their sexual orientation, because they worry about discrimination affecting the quality of health care they receive. This can make it harder to have a comfortable relationship with a provider.1
  • Negative experiences with health care providers: Fear of having a negative experience with a health care provider 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 often harder to treat. 

Today, there are many lesbian, gay, bisexual, and transgender/transsexual (LGBT)-friendly providers. An LGBT community center or group may be able to refer you to these providers. 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 be healthy.

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. 

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 often 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 provider about the pros and cons of yearly prostate cancer screening starting when you’re 50. Talking about the benefits and limitations of testing can help you make an informed decision about whether to be tested. Gender identity should not keep you from having this conversation. If you’re 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. Current evidence suggests that gay and bisexual men are much more likely to smoke than heterosexual men.1,2 Smoking is responsible for 80% of all lung cancer deaths in the US. Smoking is also linked to many other types of cancer and causes other tobacco-related diseases, too, such as heart disease, bronchitis, stroke, and emphysema. Research further has shown that smoking significantly reduces the life expectancy of HIV-positive men who have the virus under control.3

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 can often be prevented simply by not smoking. If you don’t smoke, don’t start. It’s also important to reduce your exposure to secondhand smoke by seeking smoke-free places. If you or a loved one smokes, talk to a health care provider about quitting, or call us at 1-800-227-2345 to find out how we can help improve the chances of quitting for good. 

Certain men at high risk for lung cancer may want to talk to a health care provider about whether getting a yearly low-dose CT scan to screen for early lung cancer is right for them. Screening tests may benefit current or former smokers between the ages of 55 and 74, who are in good health, and who have at least 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.) The benefits, limitations, and risks of screening should be discussed with a provider before it’s done.

Colon cancer

Who is at risk?

Most colorectal cancers (commonly called colon cancers) are found in people age 50 or older. People with a personal or family history of the disease, colon or rectal polyps, inflammatory bowel disease, or type 2 diabetes are at greater risk. Being overweight, eating a diet high in red and processed meats, heavy alcohol use, smoking, and being inactive also increase risk. 

What you can do

Staying at a healthy weight, eating well, being active, not smoking, and limiting alcohol use all might help lower your risk of colon cancer.

Colon cancer almost always starts with a polyp – a small growth on the lining of the colon or rectum. Testing can often find polyps before they become cancer. If pre-cancerous polyps are removed, colon cancer can be prevented. If colon cancer is found during testing, it is more likely to be at an early stage and easier to treat. 

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

Tests that find polyps and cancer: 

  • Colonoscopy every 10 years 
  • CT colonography (virtual colonoscopy) every 5 years* 
  • Flexible sigmoidoscopy every 5 years* 
  • Double-contrast barium enema every 5 years* 

OR

Tests that find mainly cancer: 

  • Fecal immunochemical test (FIT) or guaiac-based fecal occult blood test (gFOBT) every year*, ** 
  • Stool DNA test (sDNA) every 3 years* 

* If the test is positive, a colonoscopy should be done.
** The multiple stool take-home method should be used. One test done by a health care provider isn’t enough. 

Tests that can find both polyps and cancer should be your first choice when possible. But the most important thing is to get tested, no matter which test you choose. Talk with a health care provider to find out which tests might be right for you. 

If you’re at high risk of colon cancer based on family history or other factors, you may need to start testing at a younger age. Talk to a provider about your risk for colon cancer and when you should start testing. 

Skin cancer

Who is at risk?

Anyone can get skin cancer, although it’s more common in people who spend a lot of time in the sun. People with fair skin, especially those with blond or red hair, are at greater risk than people with darker coloring. Those who have weakened immune systems or close family members with skin cancer are also at higher risk for skin cancer.

What you can do

Here are some things you can do to help prevent skin cancer: 

  • Limit the time spent in the sun, especially from 10 a.m. to 4 p.m., when its rays are strongest.
  • Protect your skin by wearing hats with wide brims, long-sleeve shirts, and sunglasses when you are outside. 
  • Use broad-spectrum sunscreen with an SPF of 30 or higher on all exposed skin. Always follow the label directions when applying. 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 health care provider. 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 help reduce your risk of anal cancer by not having many sex partners and using condoms. Quitting smoking can also help 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.

HPV vaccines can lower the risk of HPV infection, and might also lower the risk of anal cancer in some men. These vaccines are recommended up to age 26 for men who have sex with men.

Be aware of any anal or rectal symptoms, and report them to a health care provider 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.4 This test 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 may want to talk to a provider about whether this test might be right for you.

 

Testicular cancer

Who is at risk?

About half of testicular cancers occur in men between the ages of 20 and 34. White men have a higher risk than men of other races. One of the main risk factors 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 health care providers 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 provider right away if you notice changes or have any signs or symptoms of testicular cancer.

The take-away

The LGBT communities have a higher incidence of many risk factors linked to cancer. Change those you can, and encourage the people you care about to do the same:

These are some other things you can do to be healthy and help prevent cancer:

  • Eat a healthy diet with an emphasis on whole grains, fruits, and vegetables.
  • Be physically active.
  • Limit sedentary behaviors such as sitting, lying down, watching TV, and other forms of screen-based entertainment.

It’s also important to see a health care provider on a regular basis. Learn about the benefits and limitations of testing for cancer early, then get the tests that are right for you. Remember, 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. 

Notes

1 Quinn GP, Sanchez JA, Sutton SK, et al. Cancer and Lesbian, Gay, Bisexual, Transgender/Transsexual, and Queer/Questioning (LGBTQ) Populations. CA Cancer J Clin. 2015;65:384-400.

2 Jamal A, King BA, Neff LJ, et al. Current Cigarette Smoking Among Adults — United States, 2005–2015. MMWR. 2016;65(44):1205-1211.

3 Siddiqi K, Mdege N. Smoking: A Major Roadblock in the Fight Against AIDS. Nicotine Tob Res. 2016;18(12):2175-2176.

4 Ruanpeng D, Chariyalertsak S, Kaewpoowat Q, et al. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand. PLoS One. 2016;26;11(5):e0156280.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: January 25, 2017 Last Revised: July 7, 2017

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