The Influence of Tobacco Use, Hazardous Drinking, and Other Risk Factors on HPV-Associated Oropharyngeal Cancer Risk and Screening Perceptions Among Gay and Bisexual Men: A Cross-Sectional Study

Authors

Language

English

Publication Date

3-30-2025

Journal

BMC Oral Health

DOI

10.1186/s12903-025-05774-0

PMID

40159495

PMCID

PMC11955142

PubMedCentral® Posted Date

3-30-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords

Humans, Male, Cross-Sectional Studies, Oropharyngeal Neoplasms, Risk Factors, Alcohol Drinking, Adult, Papillomavirus Infections, Middle Aged, Homosexuality, Male, Tobacco Use, Sexual and Gender Minorities, Health Knowledge, Attitudes, Practice, Bisexuality, Early Detection of Cancer, LGBTQ, Gay, Cigarette smoking, Vaping, Alcohol use, Oral sex, Oral health, Oropharyngeal cancer, Health education, Men who have sex with men, HPV

Published Open-Access

yes

Recommended Citation

, "The Influence of Tobacco Use, Hazardous Drinking, and Other Risk Factors on HPV-Associated Oropharyngeal Cancer Risk and Screening Perceptions Among Gay and Bisexual Men: A Cross-Sectional Study" (2025). Faculty, Staff and Student Publications. 113.
https://digitalcommons.library.tmc.edu/uthdb_docs/113