Zoschke I Niles, Bennis Sarah L, Tang Yi, Wilkerson J Michael, Stull Cynthia L, Nyitray Alan G, Khariwala Samir S, Nichols C Mark, Rosser B R Simon, Flash Charlene A, Ross Michael W
Alcohol Research Group, University of California at Berkeley, Berkeley, CA, US.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
BMC Oral Health. 2025 Mar 30;25(1):462. doi: 10.1186/s12903-025-05774-0.
Oropharyngeal cancer is the eighth most common cancer among US men and its incidence is sharply rising. Oropharyngeal cancer manifests in two major ways: the classic form is prevalent among people who use alcohol and tobacco heavily, while a growing subset of incident cases is associated with human papillomavirus-16 (HPV) and transmitted via oral sex. Gay and bisexual men appear at higher risk for each etiologic subset of oropharyngeal cancer than heterosexual men. We conducted a cross-sectional study to learn how tobacco use, hazardous drinking, and other key risk factors affect gay and bisexual men's perceptions of oropharyngeal cancer risk and beliefs about screening at a doctor's office and self-screening at home.
We recruited 1,699 gay and bisexual men from two dating websites to participate in an online survey. We asked about tobacco use, alcohol consumption, sexual history, and other risk factors for oropharyngeal cancer. The survey also investigated participants' perceptions of oropharyngeal cancer risk and potential worry related to screening. We analyzed results at the bivariate level and in multivariable regression models. We used logistic regression to analyze categorical data and linear regression to analyze continuous data.
Average age of participants was 41.5 (SD = 12.7) years. Most were cisgender (95%), and identified as gay (80%), while 19% were bisexual or pansexual, with 2% reporting being queer or a self-described sexuality. Factors associated with high perceived oropharyngeal cancer risk perceptions were cigarette smoking, using both cigarettes and vaping, being gay identified, number of sexual partners in the last 12 months, and having poor mouth/teeth condition. Factors associated with oropharyngeal cancer screening worry were being Hispanic, having queer/self-described sexuality, not having health insurance, and having poor mouth/teeth condition. No factors were associated with self-screening at home. Alcohol use was not associated with oropharyngeal cancer risk perception.
This study examines oropharyngeal cancer risk perceptions among gay and bisexual men. Health promotion efforts to reduce oropharyngeal cancer risk among gay and bisexual men should involve comprehensive oral health, sexual health, and tobacco use education. Researchers should continue investigating acceptable and effective home self-screening methods for HPV-associated cancers.
口咽癌是美国男性中第八大常见癌症，其发病率正在急剧上升。口咽癌主要有两种表现形式：经典形式在大量饮酒和吸烟的人群中较为普遍，而越来越多的新发病例与人类乳头瘤病毒16型（HPV）有关，并通过口交传播。男同性恋者和双性恋男性患口咽癌的每种病因亚型的风险似乎都高于异性恋男性。我们进行了一项横断面研究，以了解烟草使用、有害饮酒和其他关键风险因素如何影响男同性恋者和双性恋男性对口咽癌风险的认知以及对在医生办公室进行筛查和在家自我筛查的看法。
我们从两个约会网站招募了1699名男同性恋者和双性恋男性参与一项在线调查。我们询问了他们的烟草使用、饮酒情况、性史以及口咽癌的其他风险因素。该调查还调查了参与者对口咽癌风险的认知以及与筛查相关的潜在担忧。我们在双变量水平和多变量回归模型中分析结果。我们使用逻辑回归分析分类数据，使用线性回归分析连续数据。
参与者的平均年龄为41.5（标准差 = 12.7）岁。大多数是顺性别者（95%），其中80% 被认定为同性恋，19% 为双性恋或泛性恋，2% 报告自己是酷儿或自述有其他性取向。与较高的口咽癌风险认知相关的因素包括吸烟、既吸烟又吸电子烟、被认定为同性恋、过去12个月中的性伴侣数量以及口腔/牙齿状况不佳。与口咽癌筛查担忧相关的因素包括是西班牙裔、有酷儿/自述的性取向、没有医疗保险以及口腔/牙齿状况不佳。没有因素与在家自我筛查相关。饮酒与口咽癌风险认知无关。
本研究调查了男同性恋者和双性恋男性对口咽癌风险的认知。为降低男同性恋者和双性恋男性患口咽癌风险而开展的健康促进工作应包括全面的口腔健康、性健康和烟草使用教育。研究人员应继续研究针对HPV相关癌症可接受且有效的家庭自我筛查方法。
