Research suggests that gay men and lesbians are less likely to have screening and testing than heterosexuals.
According to Dr Justin Varney, a public health consultant for Barking and Dagenham PCT, they may avoid screening because they think, "It’s not going to happen to me". Others may fear discrimination or simply don't think they're at risk.
Cancer affects people whatever their sexuality and one person in three develops cancer at some point in their life. Screening and testing is vital for the early detection of certain diseases and conditions, some of which may be more common in the lesbian, gay and bisexual (LGB) community.
Women
According to Ruth Hunt, head of policy and research at the charity Stonewall, lesbians and bisexual women don’t take part in NHS screening programmes enough. “Cervical cancer is preventable and curable,” she says. “No one should die of this.”
Lesbians are just as likely to develop breast cancer as straight women, so it’s crucial to undergo screening.
Lesbians are more reluctant to see their local GP and yet are more at risk from lifestyle diseases associated with smoking, drinking and obesity.
“Lesbians can be anxious about having a cervical screening test," says Hunt. "Although the test is a little intrusive, it’s really important to have one every three years between the age of 25 and 49, and every five years between the age of 50 and 64. The key message is: make the decision to get screened. It’s free on the NHS.”
Women who don't identify themselves as lesbians but who have sex with women (including those who have never had sex with a man) should have regular cervical screening tests, too.
The NHS Cervical Screening Programme offers cervical smears to all women between 25 and 64. This programme is co-ordinated by your GP and you should receive a reminder letter when your next test is due. The programme gets your details from your GP, so it's important to register with a local surgery.
Being aware of your breasts is important for all women and paying attention to how your breasts look and feel at different times of the month can help you detect any problems.
All women should follow the breast awareness five-point code:
- Know what's normal for you.
- Look and feel.
- Know what changes to look for.
- Report any changes without delay.
- Attend breast screening if you're aged 50 or over.
Changes to look out for include:
- Any change in the outline or shape of the breast or any puckering or dimpling of the skin.
- Any discomfort or pain in one breast that is different from normal.
- Any lumps, thickening or bumps in one breast or armpit that are different from normal.
- Any discharge or bleeding or moist reddish areas that will not heal easily.
- Any change in nipple position or a nipple rash.
- Women over 50 are invited for a mammogram screen (breast X-ray) every three years as they are at increased risk of breast cancer.
- You will receive your first invitation from your local screening unit before your 53rd birthday.
Men
According to Dr Varney, gay men don’t access screening in the same way as straight men. “Because of HIV, there was a culture of live hard and fast, die young and pretty, and an unfamiliarity with getting old.
"There aren't many gay role models in their 60s on TV. It’s a huge generalisation, but a lot of gay men don’t put money into savings accounts, don’t have pensions, and don’t have a concept of what it’s like to be over 50.
"And if you don’t have that, why would you bother to get screened for cancer?”
The fact is that cancer affects one in three people in the UK, and, according to Dr Varney, gay men drink and smoke more than straight men, so screening and testing is vital.
“It’s unusual for straight men in their 30s and 40s to be drinking more than 30 units a week or taking recreational drugs, but gay men tend to continue. And smoking and binge drinking are recipes for coronary heart disease and some cancers.”
In terms of STIs, gay men may be at a greater risk of certain infections. For example, gonorrhoea is more common in gay men than straight men.
Varney says the presence of any STI increases your chance of getting HIV. “STIs damage membranes, making it a lot easier for HIV to pass from one person to another. Because your body is focussed on attacking the STI, it’s less likely to mount a defence against HIV.
“Hepatitis C is a growing problem in the gay community,” says Dr Varney. “Research shows it’s no longer something you just see in injecting drug users and co-infection with HIV is becoming more of an issue."
