Gay and bisexual African-American men have the lowest use of prostate testing

Charles Drew University study examines screening exams for California males

Los Angeles, CA, 26 dec 2008—Gay and bisexual black men are less likely to be tested for prostate cancer than men of any other racial and ethnic backgrounds regardless of their sexual orientation, according to a recent study by a researcher at Charles Drew University of Medicine and Science.

In his study, published in the December issue of Medical Care, Kevin C. Heslin, an assistant professor at Charles Drew University, examined prostate and colorectal testing rates based on sexual orientation, race and ethnicity.

Using data from telephone interviews with 19,410 men who participated in the California Health Interview Survey, the research found no overall difference in the use of the prostate-specific antigen (or PSA) test among gay, bisexual and heterosexual men.

But the percentage of gay and bisexual black men who received the PSA test was 12% to 14% lower than heterosexual blacks and 15% to 28% lower than gay and bisexual whites.

"Gay and bisexual black men had the lowest use of the PSA test, compared with every other group of men in the study," Heslin said. "For blacks, being a member of both racial and sexual minority groups represents a kind of double jeopardy when it comes to getting PSA testing."

The findings are significant because black men are more likely to be diagnosed late with prostate cancer and, as a result, are more likely to die from the disease than any other racial or ethnic group.

Prostate and colorectal cancers are the second and third most common causes of cancer deaths among men in the United States, exceeded only by lung cancer.

Overall, the study found that a greater percentage of gay and bisexual men received colorectal cancer tests compared with heterosexual men, which suggests that gay and bisexual men may have better access to preventive screening than heterosexuals. But the researchers point out that the difference may be partly due to the fact that colorectal cancer tests—such as colonoscopy, sigmoidoscopy, and proctoscopy—are also used to diagnose sexual health problems among gay men.

All the men in the study were age 50 and over, which is the age at which screening for prostate and colorectal cancer is recommended by many professional organizations. The American Cancer Society guidelines recommend that African American males begin receiving the PSA screening test at age 45.

Funded by the National Institutes of Health (NIH), the study, "Sexual Orientation and Testing for Prostate and Colorectal Cancers among Men in California," suggests that health services planners seeking to address racial and ethnic disparities in prostate cancer may need to consider sexual orientation when developing culturally specific screening programs for high-risk subgroups of men, such as African Americans.

Kevin C. Heslin received his Ph.D. in Health Services Research from the University of California, Los Angeles (UCLA). He was a pre-doctoral fellow in the National Institute of Mental Health/UCLA AIDS Research Training Program. He is currently an assistant professor at Charles Drew University of Medicine and Science. His research focuses on access to health services and health outcomes in underserved populations, particularly persons with HIV/AIDS and homeless persons.