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Are gay men more at risk for cancer?

By Genevra Pittman

NEW YORK (Reuters Health) - More gay men reported being cancer survivors than straight men in a new study from California.

That suggests they may need targeted interventions to prevent cancer, the researchers said, but more studies are needed to answer lingering questions. For example, are gay men more likely to be diagnosed with cancer than straight men? Or, are they just more likely to survive if they do get cancer?

"A lack of hard data" on how sexual orientation affects the risk of cancer is "one of the biggest problems we have," said Liz Margolies, executive director of The National LGBT Cancer Network. Margolies, who was not involved in the research, told Reuters Health, "It's critical that we know that for funding and for program planning."

As a step toward addressing the lack of data, researchers looked at three years of responses to the California Health Interview survey, which included more than 120,000 adults living in the state.

Among other health-related questions, participants were asked if they had ever been diagnosed with cancer and whether they identified as gay, lesbian, bisexual, or straight.

The findings are published in the journal Cancer.

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.

However, among women who were cancer survivors, lesbian and bisexual women were more likely to report fair or poor health than straight women.

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.

Margolies 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.

"I don't think that we're going to get people to have early screening or see doctors except in emergencies ... until they can be guaranteed a safe and welcoming experience" at the doctor's office, she said.

Margolies said that while the new findings are "very important," she cautions about generalizing them too far beyond this individual study. Partially that's because she suspects lesbian women may also have an increased risk of cancer compared to straight women, because they have some of the same risk factors as gay men.

But Margolies and Boehmer agree that there is still an important message to take away from the findings: gay, lesbian and bisexual people need more attention from the healthcare community, specifically when it comes to their cancer risks.

"Because more gay men report as cancer survivors, we need foremost programs for gay men that focus on primary cancer prevention and early cancer detection," Boehmer told Reuters Health in an email.

And, "Because more lesbian and bisexual women than heterosexual women with cancer report that they are in poor health, we need foremost programs and services that improve the well-being of lesbian and bisexual cancer survivors," she added.

"Health care facilities and social service agencies -- any organization that addresses the needs of cancer survivors -- must understand the extra challenges that lesbian and bisexual cancer survivors and gay men have," Margolies concluded.

SOURCE: http://bit.ly/gzHzeL Cancer, online May 9, 2011.

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