Higher Cancer Risks for Gay and Bisexual Men: Prevention and Screening

Hearing the words “higher cancer risk” is scary enough. Add “for gay and bisexual men,” and it can feel downright overwhelming.
But here’s the good news: higher risk does not mean “nothing you can do.” It means the oppositethere are very specific, powerful steps you can take to stack the odds back in your favor.

Research over the past decade has confirmed that sexual and gender minority people, including gay and bisexual men, face cancer disparities at nearly every stage: risk, diagnosis, treatment, and survivorship.
Those gaps aren’t because being gay or bi somehow “causes” cancer. They’re mostly about things like infections (HPV, HIV, hepatitis), smoking, alcohol use, tanning, lower screening rates, and barriers in health care.

Let’s walk through what those higher risks look like, how prevention and screening can help, and how to navigate a system that still isn’t always built with gay and bisexual men in mindall with a bit of humor and a lot of practicality.

Why Cancer Risk Can Be Higher for Gay and Bisexual Men

Studies in the U.S. show that LGBTQ+ people are more likely to live in poverty, be uninsured, and delay carethree big ingredients in the “how did this get so advanced?” cancer story.
On top of that, gay and bisexual men may have:

• Higher rates of tobacco and alcohol use
• More exposure to HPV through receptive anal sex
• Higher rates of HIV in some groups
• Higher odds of using indoor tanning (and getting sunburns) compared with straight men
• Less trust in the health care system due to discrimination or bad experiences

Put those together and you get a perfect storm: more risk factors, fewer checkups, and later diagnoses. The goal isn’t to blame anyone; it’s to name the pattern so you can break it.

Key Cancers Gay and Bisexual Men Should Watch Closely

1. Anal Cancer and HPV: The Big One No One Likes to Talk About

Anal cancer is rare in the general populationabout 2 cases per 100,000 people per yearbut that number skyrockets for men who have sex with men (MSM). Estimates suggest HIV-negative MSM may be about 20 times more likely to be diagnosed with anal cancer, and HIV-positive MSM up to 40 times more likely.

The main culprit: human papillomavirus (HPV), the same virus that can cause cervical, penile, and throat cancers. High-risk HPV types are much more common in gay and bisexual men, especially those living with HIV.

The twist? Awareness is still patchy. Studies show many gay and bi men don’t know HPV can cause anal cancer, even though HPV vaccines and screening can significantly reduce risk.

2. Colorectal Cancer: Risk Factors and Lower Screening Rates

Colorectal cancer (cancer of the colon or rectum) is a major killer for all genders. For most people, screening now starts at age 45 according to major U.S. guidelines.

For LGBTQ+ communities, the issue isn’t that the colon is differentit’s that the context is. Discrimination, mistrust, and bad experiences with providers mean many gay and bisexual men delay recommended colonoscopies or never get screened at all. One national colorectal cancer initiative notes that about 1 in 6 LGBTQ+ adults avoid health care because of prior discriminationexactly the kind of thing that leads to later-stage diagnosis.

3. Skin Cancer: Tanning Beds and Beach Pride

A study referenced in JAMA Dermatology found that gay and bisexual men had significantly higher odds of skin cancer compared with heterosexual men, likely linked to higher rates of indoor tanning and sunburn.

Translation: if you love a golden glow, your skin may be paying the price long-term. UV rays don’t care about your aestheticthey just damage DNA.

4. Lung and Liver Cancer: Smoking and Hepatitis

Sexual and gender minority populations, as a group, have higher smoking rates than straight, cisgender peers. That means higher risk of lung cancer and several other cancers.

Gay and bisexual men are also at higher risk of hepatitis B infection, and some may also have hepatitis C. Both viruses can lead to chronic liver disease and liver cancer. U.S. guidelines recommend screening MSM for hepatitis B and vaccinating those who aren’t protected.

5. Prostate Cancer: Same Organ, Different Experience

Prostate cancer risk is driven mostly by age, family history, and race. Gay and bisexual men don’t necessarily have a higher baseline risk than straight men, but they may face special issues:

• Less likely to have a regular primary care provider they trust
• More likely to have had negative experiences during rectal exams
• Confusion about whether receptive anal sex affects prostate cancer risk (short answer: no clear evidence it does)

The American Cancer Society recommends talking with a doctor about prostate cancer testing around age 50 for men at average risk, earlier (around 45 or 40) if you’re higher risk (for example, strong family history or being Black).
The key is shared decision-makingnot silently hoping everything is fine.

Barriers to Prevention and Screening (and How to Push Back)

It’s impossible to talk about cancer in gay and bisexual men without talking about the health system itself. Many LGBTQ+ people report having to “teach” their providers about their lives, or facing outright hostility.

Common barriers include:

• Fear of being judged for sexual behavior or HIV status
• Previous experiences of discrimination in clinics or emergency rooms
• Insurance gaps or financial stress
• Clinicians who assume all patients are straight and skip key questions

These aren’t “personal weaknesses.” They’re structural problems. But you can still take steps to protect yourself while we keep pushing for a better system:

• Look for LGBTQ+-affirming clinics, community health centers, or providers recommended by local queer networks.
• Bring a friend or partner for emotional backup if medical settings make you anxious.
• Write down questions in advance so you don’t freeze in the exam room.

Prevention: What You Can Actually Control

You can’t change your age, genetics, or the fact that some systems still don’t fully see you. But you have more control than you might think over other risk factors.

Get the Right Vaccinations

HPV vaccine isn’t just for teens. In the U.S., HPV vaccination is recommended up to age 26 and can be considered up to age 45 after a discussion with your provider. It helps protect against the HPV types most likely to cause anal, penile, oral, and other cancers.

Hepatitis A and B vaccines are recommended for MSM who aren’t already immune. That’s a big deal for preventing chronic liver disease and liver cancer down the line.

Protect Yourself from HIVand Treat It Aggressively If You Have It

HIV doesn’t just affect the immune systemit amplifies the risk of several cancers, especially those linked to viruses like HPV. Gay and bisexual men with HIV have some of the highest anal cancer rates reported in any group.

Practical steps:

• If you’re HIV-negative but at risk, talk to a provider about PrEP.
• If you’re living with HIV, staying on effective antiretroviral therapy is crucial for lowering cancer risk and improving treatment outcomes.
• Regular STI screening (at least annually, and more often if you have multiple partners) is recommended for MSM at sites of exposure (urethra, rectum, throat).

Quit Smoking and Re-Think Tanning

Smoking is still one of the biggest modifiable cancer risks on earth. If you smoke, quitting is one of the best “anti-cancer” moves you can possibly makemore effective than any supplement, detox, or miracle tea.

As for tanning: that bronze “summer glow” is literally DNA damage. If you’re a fan of tanning beds or all-day shirtless festivals, it’s time to upgrade to sunscreen, hats, and shade. Remember that research shows gay and bi men have higher odds of skin cancer than straight menno beach body is worth melanoma.

Move Your Body, Feed It Decently, Sleep Sometimes

Movement doesn’t have to mean becoming a gym influencer. Even regular brisk walking helps lower the risk of colorectal and other cancers, especially when combined with maintaining a healthy weight and limiting processed meats and heavy alcohol use.

Screening Essentials for Gay and Bisexual Men

One of the most helpful principles from LGBTQ-focused cancer organizations and the American Cancer Society is:
“If you’ve got it, screen it.” In other words, get screened based on the organs and tissues you have, not just your gender marker or orientation.

Anal Cancer Screening

Unlike cervical cancer, there’s no nationwide, standardized anal cancer screening programyet. But many experts recommend some form of screening for people at high risk, including:

• Gay and bisexual men, especially those living with HIV
• Anyone with a history of anal warts or high-risk HPV

Screening can include:

• Regular digital anorectal exams (yes, the gloved-finger exam)
• Anal Pap tests or high-resolution anoscopy in specialized clinics

Evidence is still evolving, but professional groups focused on HIV and anal cancer strongly support screening high-risk MSM to detect pre-cancerous changes early.

Colorectal Cancer Screening

For most people at average risk, colorectal cancer screening starts at age 45. Options include colonoscopy, stool-based tests, or other imaging.

Because LGBTQ+ adults are more likely to delay care, some may reach their late 40s or 50s having never been screened. If that’s you: no shame, just start now. Your future self will not be mad that you did a mildly embarrassing test to avoid a life-threatening disease.

Prostate Cancer Screening

Prostate cancer screening usually involves:

• A prostate-specific antigen (PSA) blood test
• Sometimes a digital rectal exam

Current U.S. recommendations emphasize shared decision-making. For men at average risk, the conversation often starts around age 50; for higher-risk men, as early as 45 or 40.

If rectal exams are especially uncomfortable because of past trauma or dysphoria, tell your provider. A good clinician will explain why the exam is being done, talk through options, and proceed with consent and gentlenessor help you find a provider who will.

Skin Cancer Checks

Gay and bisexual men have higher odds of skin cancer than straight men, so regular skin checks are important.

• Do monthly self-checks: look for new or changing moles, spots that itch, bleed, or look “weird.”
• Ask a partner or friend to check areas you can’t see (also a great excuse for a back massage).
• Request a full-body skin exam from a dermatologist if you have a history of tanning, lots of moles, or previous skin cancers.

Finding LGBTQ+-Affirming Cancer Care

You deserve health care that doesn’t treat your orientation as an awkward side note or a problem to “work around.” LGBTQ-focused cancer organizations and many large cancer centers now offer:

• Clinics explicitly welcoming sexual and gender minorities
• Staff trained in inclusive language and trauma-informed care
• Support groups specifically for gay, bi, and trans people with cancer

If you can, ask local LGBTQ centers, online support groups, or HIV organizations for provider recommendations. “Queer-approved doctor” is a very real and useful category.

Real-Life Experiences: What Prevention and Screening Look Like

Statistics are useful, but they don’t tell you what it feels like to sit in a gown on a crinkly paper sheet waiting for a doctor to talk about your anus. So let’s look at some composite storiesbased on real patterns clinicians and LGBTQ advocates see every day.

Alex, 32: Saying Yes to the HPV Vaccine “Late”

Alex came out in his late 20s and spent a few years doing what many of us do: learning the apps, discovering brunch, and not thinking much about vaccines beyond COVID shots. At 31, he finally saw a primary care doctor who asked a simple question: “Have you ever had the HPV vaccine?”

Alex had assumed he’d aged out. His provider explained that while the vaccine works best when given before sexual exposure, U.S. guidelines allow vaccination up to age 45 after a shared decision-making conversation. Given Alex’s number of partners and his interest in bottoming, he decided the extra protection was worth it.

Was it a magic shield? No. But it was a concrete step he could take, and that shifted his mindset from “cancer is a lottery” to “I actually have levers I can pull.”

Brian, 48: The Colonoscopy He’d Been Avoiding

Brian is a bisexual man in a long-term relationship with a woman; he’s out to his partner but not to his family. He’d had some bad experiences with doctors who made jokes about “lifestyle choices,” so he mostly stayed away from medical offices unless something was on fire.

When he turned 48, his partner gently nagged him into seeing a doctor and mentioned the word “colonoscopy.” Brian’s first reaction: absolutely not. But his clinicianin an LGBTQ-affirming clinictook time to explain the options: stool tests, colonoscopy, and the pros and cons of each.

He opted for a colonoscopy, grumbled through the prep, and woke up to hear: “We found and removed two polyps that could have become cancer later.” Annoying? Yes. Life-saving? Quite possibly.

Jorge, 41 and Living with HIV: Anal Screening That Caught Changes Early

Jorge has been living with HIV for a decade and has an undetectable viral load. His HIV specialist brought up anal cancer risk and recommended anal Pap tests and high-resolution anoscopy at a specialty clinic. Jorge had never heard of anal Pap tests and was… not thrilled.

But because his partner’s older friend had recently been treated for anal cancer, he agreed. The screening showed high-grade anal intraepithelial neoplasiapre-cancerous changes. Those were treated before they turned into invasive cancer.

Jorge later said the experience changed how he thought about prevention. “If you tell me to eat more kale, I’ll laugh. If you tell me you can zap something before it becomes cancer, I’ll show up every year.”

Marcus, 55: Facing Prostate Screening After Avoiding Doctors for Years

Marcus, a gay Black man, had watched older relatives deal with prostate cancer but still avoided doctors. When a friend was diagnosed at 57 with advanced disease, Marcus finally booked an appointment.

His provider explained PSA testing, the role of age and race, and the controversy around overdiagnosis. Together they decided to start regular PSA screening and to repeat it every 1–2 years if results stayed low.

He later joked, “The blood test was easy. The hard part was realizing I should’ve asked these questions ten years ago.”

Bottom Line: You Deserve Long, Healthy, Unapologetically Queer Years

Higher cancer risks for gay and bisexual men are realbut they’re not destiny. They’re a signal: vaccinate, screen, quit smoking if you can, protect your skin, and push (politely or loudly) for care that respects who you are.

Prevention and screening won’t erase every risk, but they dramatically increase the chance that if cancer shows up, it’s found early, when treatment is most effective and your life plans are barely interrupted.

You deserve providers who see you fully, data that includes you, and a future where “gay and bisexual men” show up in cancer statistics for good reasonslike living longer and surviving more.