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This gap in the literature is a concern from both public health and clinical perspectives, given the relatively high prevalence of HIV in the gay/bisexual male population. Several studies suggest that lesbians are less likely than heterosexual women to receive cancer screening 13 however, no quantitative analyses have compared the use of cancer tests between gay/bisexual and heterosexual men. 7 – 12 Relatively little information, however, is available on the association of cancer testing with sexual orientation.
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Previous work has shown that the use of prostate and colorectal cancer testing differs by patient race/ethnicity, income, education, and other characteristics. 5 Although stronger evidence exists for the efficacy of routine CRC testing, national data suggest that men in the general population are more likely to be tested for prostate cancer. Preventive Services Task Force has concluded that current evidence does not support PSA testing. For example, the American Cancer Society recommends annual PSA testing for men age 50 and over, 4 whereas the U.S. 2, 3 By contrast, there is less support from randomized controlled trials for the use of prostate-specific antigen (PSA) testing, and a low level of agreement between different clinical preventive guidelines. 1 Colorectal cancer (CRC) screening is widely recommended for adults age 50 and over, based on evidence that early detection can decrease cancer incidence and mortality through the identification of preclinical lesions. Prostate and colorectal cancers are the second and third most common causes of cancer deaths among men in the United States, exceeded only by lung cancer.