Gay and bisexual men at higher risk of cancer: prevention and screening

Kenneth Meyer, MD, director of medical research and co-chairman of the Fenway Institute in Boston, recommends four steps to reduce the risk of cancer in gay and bisexual men:

• Quit smoking (good advice for everyone)
• Drink less (also a good tip for everyone)
• Get vaccinated against HPV and viral hepatitis
• Get tested for HIV (good advice for everyone too)

HPV vaccination

The HPV vaccine has been used for more than 15 years and is now approved for boys and men between the ages of 9 and 45. The idea behind the age cutoff is that by middle age, most men have had most of their sexual partners and thus have been exposed to the HPV vaccine. Various strains of HPV. But Meyer said there is still value in getting vaccinated later in life.

“Even if you can reduce your risk of cancer by 5 percent, I think it’s worth it (getting vaccinated),” he said. “As long as you can pay out of pocket, there’s no downside to getting vaccinated.”

Most insurance companies will not cover the cost of HPV vaccination if you are over 45, making the three-shot vaccine a serious financial strain. The jury is still out on how effective the HPV vaccine is in preventing oropharyngeal cancer.

Hepatitis B vaccination

People who are chronically infected with hepatitis B are at greater risk of developing liver cancer throughout their lives. According to the CDC, gays, bisexuals, and MSM are at greater risk for hepatitis B, which is spread through semen and blood during sexual activity. Hepatitis A, which is usually spread to the mouth through feces, is another risk to the liver. The CDC recommends that all men who have sex with men get vaccinated against hepatitis A and hepatitis B.

HIV testing

HIV is a strong predictor of increased anal cancer risk, in part because condomless sex is a driver of HIV, HPV, and hepatitis B. A positive HIV test result should alert the doctor to order additional screening tests. Because your primary care doctor may not automatically prescribe these tests, you may need to request them. This requires you to be comfortable talking about your sexuality.