Study finds racial inequalities in cancer screening

Gay and bisexual African-American men are least likely to be screened for colorectal and prostate cancer

African-American men are more likely than men of any other racial category to develop and die of prostate cancer. A recent study suggests that a lack of screening may be to blame.

According to the study “Sexual Orientation and Testing for Prostate and Colorectal Cancers among Men in California,” published in the December 2008 issue of Medical Care, bisexual and gay African-American men are the cohort least likely to be screened for prostate cancer.

This study, lead by Kevin C. Heslin, an assistant professor at Charles Drew University, was based upon data from 19,410 men who self-identified as gay or bisexual in the California Health Interview Survey. The Survey was conducted through direct telephone interviews of a representative sample of men over 50 years of age – the age at which the majority of healthcare institutions suggest that men begin to undergo regular screenings for both prostate and colorectal cancer.

The data examined revealed that prostate-specific antigen (PSA) screenings were done 12 per cent to 14 per cent less often on gay and bisexual African-American men when compared to heterosexual African-American men, and 15 per cent to 28 per cent less oftern when compared to gay and bisexual Caucasian men. The study also found that African-American men on the whole are less likely to be screened than Caucasian or Latino men, regardless of sexual preferences.

“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,” Heslin said in a December 2008 news release.

Despite this study’s findings, overall, gay and bisexual men are more likely than heterosexuals to receive regular screenings for colorectal of cancer. This may be due to the fact that gay and bisexual men tend to be more conscious of the need for screening revolving around sexual health, researchers say.

Prostate cancer is the second largest killer of men in the United States, and early access to PSA testing is imperative for its prevention or detection and treatment. However, the results of the California colorectal screening study reveal the discrepancies in access to public health services for minority or marginalized populations.

The conclusion of the California study is aimed at making the statistics more than just numbers. The study includes the recommendation that those responsible for health service planning take race, ethnicity, and sexual orientation into account when developing screening programs, especially those programs aimed at high-risk populations.