Risk for cancer in gay, bisexual and transgender men via infection

Abstract

A number of infections play a significant role in cancer risk for gay, bisexual and transgender (GBT) men. The association between Human Immunodeficiency Virus (HIV), the virus that attacks and degrades the immune system, frequently leading to Acquired Immune Deficiency Syndrome (AIDS) and cancer, has been studied extensively. In addition, human papillomavirus (several types), human herpes virus (also several types), and Hepatitis virus (primarily Hep B and Hep C), each contribute to additional cancer risk in the form of infection-related cancers. This chapter reviews these infections and associated cancers among GBT men including viral transmission and prevalence both independently and in comparison to other men. It further explores the risk of cancer associated with these infections and, given the wide varieties and potential cancer sites, where elevated cancer rates have been observed. In response to these elevated risks, efforts to improve screening, educate GBT men about the increased risk, and new treatment strategies have been implemented. This chapter explores how programs to address infection-related cancer in GBT men have fared to date, including efforts to reduce transmission of infectious agents, early intervention and screening, cost effectiveness of screening, advances in cancer treatment itself, and changes in knowledge, attitudes and behavior among GBT men. The chapter ends with unique challenges with respect to treatment of GBT men with infection related cancers.