Disparities in Health Risk Behavior and Psychological Distress Among Gay Versus Heterosexual Male Cancer Survivors

Abstract

Gay men have been found to have higher rates of cancer diagnoses than heterosexual men and poorer outcomes postcancer diagnosis. The two aims of this study were to examine rates of cancer diagnosis in a national sample of gay and heterosexual men, and to examine disparities in health risk behavior between gay and heterosexual men and gay and heterosexual cancer survivors. The current study utilized data from a total sample of 14,354 men, including 373 gay men, collected as part of the Behavioral Risk Factor Surveillance System survey conducted in 2009 in the states of Arizona, California, Massachusetts, Ohio, and Wisconsin. This study replicated the finding that prevalence of self-reported cancer diagnoses differed significantly between gay and heterosexual men, with gay men 82% more likely to report a lifetime history of cancer diagnosis (p<0.05); however, this disparity became nonsignificant after controlling for a weakened immune system proxy variable (p=0.06). Gay men were more likely than heterosexual men to report health risk behaviors, including less time spent exercising, more psychological distress, more current alcohol use, more current smoking, and a lifetime history of smoking. Some of these disparities in health risk behavior persisted for gay cancer survivors postcancer diagnosis. This study offers a perspective on behavioral risk factors previously shown to be higher among gay men that may continue postcancer diagnosis. Future research should test the degree to which these disparities are caused by minority stress, as previous studies have indicated that increased health risk behaviors among sexual minority populations may result from exposure to chronic stress and discrimination. Developing behavior change interventions to address these risk behaviors is vital for improving cancer outcomes among gay men.

Keywords: cancer; health disparities; men; oncology; risk behavior; sexual orientation.