Study also finds that lesbians, bisexual women report poorer health than straight women after surviving cancer
DAVID TAFFET | Staff Writer
A new study released this week in Cancer, a journal published by the American Cancer Society, suggests that gay men have a higher prevalence of cancer than heterosexual men.
Data came from interviews done in 2001, 2003 and 2005 of cancer survivors in California and was the largest state health survey to include questions about sexual orientation.
Lesbian and bisexual women who survived cancer reported poorer health, but in this study did not contract cancer at a higher rate. Male cancer survivors do not report a difference in health levels.
Researchers were not sure if gay men were developing more cancerous tumors or if their survival rate was actually higher. The survey interviewed more than 122,000 survivors. No study has tracked people who died of cancer by sexual orientation.
The study did not look into causes for the differences, but a number of reasons have been suggested.
Gay men smoke at a higher rate than the general population, which may account for some of the higher cancer rate.
Bret Camp, associate executive director of health and medical services at Nelson-Tebedo Clinic, suggested two causes for the difference in rate between gay and straight men.
Certain cancers develop as opportunistic infections related to HIV, which might partially explain the difference, he said. The study did not factor in HIV or track how many participants were HIV-positive.
Camp also suggested that another factor might be the human papillomavirus. HPV is sexually transmitted and can cause anal cancer.
Physician assistant Trew Deckard said, “Ano-rectal cancer is highest among HIV-positive gay men [some literature points to at least 35 times the general population], and the second highest rate of ano-rectal cancer is found in HIV-negative gay men.”
He said that ano-rectal cancer found in greater rates in both HIV-positive and -negative gay men is related to the presence of high-risk HPV types found in these populations.
While smoking traditionally has caused most oral cancer, the rate has jumped 225 percent since 1974. A 2007 study published in the New England Journal of Medicine found that people who had oral sex with six or more different partners in a lifetime are almost nine times more likely to contract oral cancer.
According to the report, gay men also developed cancer on average 10 years younger than straight men. Cancers that result from sexually transmitted diseases may account for that difference as well.
Cancer in lesbians
The difference in reported levels of health among women may be a result of a number of factors.
According to Andra Baker who ran a lesbian support group for cancer survivors at Gilda’s Club in Dallas, now known as Cancer Support Community, lesbians tend to access regular health care less frequently than straight women.
“Lesbians don’t go to the doctor as much,” she said.
That may mean that many lesbians and bisexual women are not as likely to detect their cancers at an early stage, making recovery for them more difficult.
The study did not collect information on stage of diagnosis or whether straight women on average report better health because they are recovering from a smaller tumor.
Baker said social support does affect survival and was somewhat surprised by the results showing worse health among lesbian and bisexual survivors.
“Women who attended my group didn’t have lower health or rates of survival,” she said.
But she was working with women who did seek out support, she said.
Baker, who is a survivor herself, said that people who jump into the fight are the ones who do better. She cited Lance Armstrong as an example of someone who adopted a competitive attitude to beat his cancer.
“Stress has a negative effect on the immune system,” she said.
Ulrike Boehmer, one of the study’s authors, put forward the idea of minority stress. Discrimination, prejudice and even violence experienced by lesbians and bisexual women take their toll on psychological health, which can affect overall well being, according to Boehmer.
Just having to come out to each health care provider can be stressful. Hiding people in a survivor’s support system can have a negative effect on recovery, Boehmer said.
She suggested that the study should be used to develop new services for the LGB population including cancer prevention and early detection programs for men and well being programs for women.