Prostate Cancer Screening for Gay Men in the United States



      To elucidate trends of prostate-cancer (PCa) screening in gay and bisexual men and assess the association of sexual orientation with PCa screening in the United States of America.


      Data for men ≥40 years-old with no history of PCa were collected from the National Health Interview Survey for the years 2013, 2015, and 2018. Multivariable logistic regression models were created to determine the associations between sexual orientation and PCa screening and the discussion of advantages and disadvantages prior to PCa screening.


      Gay men screened for prostate cancer were younger than their straight counterparts with a median age (IQR) of 58 years (52-66) vs 64 years (56-71). Gay men were more likely to have undergone a screening PSA test (OR 1.56; 95% CI 1.20-2.02) and discuss the advantages of PSA testing with the physician prior to the test (OR 1.64; 95% CI 1.22-2.21) when compared to straight men. In yearly analysis, gay men were more likely to have undergone screening in 2013 (OR 1.65, 95% CI 1.01-2.68) and 2015 (OR 1.95, 95 CI% 1.30-2.91), however, there was no difference when compared to straight men in 2018 (OR 1.32, 95% CI 0.85-2.04).


      Gay men were screened for PCa at a younger age comparted to straight men. They were also more likely to have undergone PCa cancer screening than straight men between 2013 and 2018. Further study is needed to better understand the role of sexual orientation in PCa screening and management.


      aOR (Adjusted odds ratio), AUA (American Urological Association), NHIS (National Health Interview Survey), OR (Odds ratio), PCa (Prostate cancer), PSA (Prostate-specific antigen), US (United States of America)
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        • American Cancer Society
        Cancer Facts & Figures 2019.
        Published online 2019 (Available at:)
        • Fedewa SA
        • Ward EM
        • Brawley O
        • Jemal A
        Recent patterns of prostate-specific antigen testing for prostate cancer screening in the United States.
        JAMA Intern Med. 2017; 177: 1040-1042
      1. H. Ballentine Carter, Peter C. Albertsen, Michael J. Barry, et al. American Urological Association - Early Detection of Prostate Cancer. Available at: Accessed January 1, 2018.

      2. Gates GJ. LGBT Demographics: Comparisons among population-based surveys. Published online September 1, 2014. Available at: Accessed August 8, 2020.

        • Gonzales G
        • Przedworski J
        • Henning-Smith C
        Comparison of health and health risk factors between lesbian, gay, and bisexual adults and heterosexual adults in the United States: results from the national health interview survey.
        JAMA Intern Med. 2016; 176: 1344-1351
        • Blosnich JR
        • Hanmer J
        • Yu L
        • Matthews DD
        • Kavalieratos D
        Health care use, health behaviors, and medical conditions among individuals in same-sex and opposite-sex partnerships.
        Med Care. 2016; 54: 547-554
        • Rice CE
        • Vasilenko SA
        • Fish JN
        • Lanza ST
        Sexual minority health disparities: an examination of age-related trends across adulthood in a national cross-sectional sample.
        Ann Epidemiol. 2019; 31: 20-25
        • Margolies L
        • Brown CG
        Current state of knowledge about cancer in lesbians, gay, bisexual, and transgender (LGBT) people.
        Semin Oncol Nurs. 2018; 34: 3-11
        • Charkhchi P
        • Schabath MB
        • Carlos RC
        Modifiers of cancer screening prevention among sexual and gender minorities in the behavioral risk factor surveillance system.
        J Am Coll Radiol. 2019; 16: 607-620
        • Heslin KC
        • Gore JL
        • King WD
        • Fox SA
        Sexual Orientation and testing for prostate and colorectal cancers among men in california.
        Med Care. 2008; 46: 1240-1248
        • Pucheril D
        • Berg S
        • Cole AP
        • et al.
        MP77-18 impact of sexual orientation on contemporary rates of prostate cancer screening.
        J Urol. 2018; 199
      3. Blewett L, Rivera Drew J, King M, Williams K. IPUMS Health Surveys: National Health Interview Survey, Version 6.4. Published 2019. Available at: Accessed 10 March 2020.

        • Boehmer U
        • Cooley TP
        • Clark MA
        Cancer and men who have sex with men: a systematic review.
        Lancet Oncol. 2012; 13: e545-e553
        • Wassersug RJ
        • Lyons A
        • Duncan D
        • Dowsett GW
        • Pitts M.
        Diagnostic and outcome differences between heterosexual and nonheterosexual men treated for prostate cancer.
        Urology. 2013; 82: 565-571
        • Blank TO
        Gay men and prostate cancer: invisible diversity.
        J Clin Oncol. 2005; 23: 2593-2596
        • James LJ
        • Wong G
        • Craig JC
        • et al.
        Men's perspectives of prostate cancer screening: a systematic review of qualitative studies.
        PLoS One. 2017; 12 (Waller J, ed.)e0188258
        • Almeida ÉS
        • Souzas R
        • Dos-Santos EM.
        “Afectados por el tacto”: sentidos atribuidos por hombres a las prácticas de prevención del cáncer de próstata.
        Salud Colect. 2020; 16: e2176
        • Ravenhill JP
        • de Visser RO
        “There are too many gay categories now”: discursive constructions of gay masculinity.
        Psychol Men Masculinity. 2017; 18: 321-330
        • Ma SJ
        • Oladeru OT
        • Wang K
        • et al.
        Prostate cancer screening patterns among sexual and gender minority individuals.
        Eur Urol. Published online November 2020;
        • Carter HB
        Prostate-Specific Antigen (PSA) screening for prostate cancer: revisiting the evidence.
        JAMA. 2018; 319: 1866
        • Ferrante JM
        • Shaw EK
        • Scott JG
        Factors influencing men's decisions regarding prostate cancer screening: a qualitative study.
        J Community Health. 2011; 36: 839-844
        • Kent EE
        • Wheldon CW
        • Smith AW
        • Srinivasan S
        • Geiger AM
        Care delivery, patient experiences, and health outcomes among sexual and gender minority patients with cancer and survivors: a scoping review.
        Cancer. 2019; 125: 4371-4379
        • Loeb S
        • Carter HB
        • Catalona WJ
        • Moul JW
        • Schroder FH
        Baseline prostate-specific antigen testing at a young age.
        Eur Urol. 2012; 61: 1-7
        • Caldwell JT
        • Ford CL
        • Wallace SP
        • Wang MC
        • Takahashi LM
        Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
        Am J Public Health. 2016; 106: 1463-1469