Let's talk about anal cancer for moment.

Sorry for the PSA, but this is something I've wanted to mention for a while and it rarely fits neatly into conversation. First, let me explain why this is on my mind.

I work in a hospital department that assists cancer patients in one of the most densely gay populations in the US. I would even say that gay men make up the majority of our patients. I see 1-3 patients with anal cancer per week, often in advanced stages. Prior to coming here, it was maybe 1-2 per year. That can't be a coincidence.

We know that HPV is exceptionally common, especially among those of us too old for the vaccine, and that some strains can lead to certain types of cancers. We hear about cervical and throat cancer, but anal cancer is lost in the footnotes. Even HPV-related penile cancer gets more attention, despite being 800% less likely.

Unfortunately, very little HPV research has been devoted to men in general, let alone gay men. At the same time, we are seeing increasing pushback against LGBTQ+ health providers. And if you don't think this matters, when was the last time a hetero-focused doctor discussed your anal health?

The overall point here is that, as a gay man, don't let this area of your health be overlooked. You may need to initiate the conversation with your healthcare provider. You may need to push for tests like a Pap smear and/or more frequent colonoscopies. And if your provider dismisses your concerns, get a new one.