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Sexual Orientation and Testing for Prostate and Colorectal Cancers Among Men in California

Heslin, Kevin C. PhD*; Gore, John L. MD; King, William D. MD, JD; Fox, Sarah A. EdD, MSPH

doi: 10.1097/MLR.0b013e31817d697f
Original Article

Background: Previous quantitative studies have not compared the use of prostate and colorectal cancer (CRC) testing between gay/bisexual and heterosexual men.

Methods: We analyzed cross-sectional data on 19,410 men in the California Health Interview Survey. The percentage of respondents age 50 and over who received prostate and CRC tests was calculated across subgroups defined by self-reported sexual orientation, race/ethnicity, and a combined variable on sexual orientation and race/ethnicity. Multivariate regression analysis was used to identify variables on respondent characteristics that were independently associated with testing.

Results: In bivariate analyses, the percentage of gay/bisexual men receiving CRC tests was 6–10% greater than that of heterosexuals. There were no overall differences in prostate-specific antigen (PSA) test use between gay/bisexual and heterosexual men; however, use of these tests by gay/bisexual African Americans was 12–14% lower than that of heterosexual African Americans and 15–28% lower than that of gay/bisexual whites. In multivariate analyses, gay/bisexual men had greater odds of ever receiving CRC tests [odds ratio (OR) = 1.67; 95% confidence interval (CI) = 1.06–2.65], and lower odds of having an up-to-date PSA test than did heterosexuals (OR = 0.61; 95% CI = 0.42–0.89). However, interactions between sexual orientation and living situation showed that gay/bisexual men who lived alone had greater odds of receiving PSA tests than did other men (OR = 1.93; 95% CI = 1.23–3.03).

Conclusions: Sexual orientation is independently associated with cancer testing among men. Future work should investigate the differences in this association by race/ethnicity and living situation.

From the *Charles Drew University of Medicine and Science, Lynwood, California; and †University of California, Los Angeles, Los Angeles, California.

Supported by the MBRS Score program (5S06GM068510-04), Agency for Healthcare Research and Quality (1R24-HS014022), and National Center for Minority Health and Health Disparities (P20-MD00182).

Dr. Gore is a fellow in the Robert Wood Johnson Clinical Scholars Program in the UCLA Department of General Internal Medicine and Health Services Research.

Reprints: Kevin C. Heslin, PhD, Research Centers in Minority Institutions, Charles Drew University of Medicine and Science, 2594 Industry Way, Lynwood, CA, 90262. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.