Sexual orientation and testing for prostate and colorectal cancers among men in California

Med Care. 2008 Dec;46(12):1240-8. doi: 10.1097/MLR.0b013e31817d697f.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • California
  • Colorectal Neoplasms / diagnosis*
  • Continental Population Groups
  • Cross-Sectional Studies
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnosis*
  • Sexuality
  • Socioeconomic Factors


  • Prostate-Specific Antigen