The Colon Cancer Coalition is looking for liked-minded partners in New York City and the surrounding area to receive one of multiple grants awarded from funds raised through Get Your Rear in Gear – New York City events. Grants will be given in amounts up to $25,000.
Applications are due Friday, February 27.
*Note: To receive funds, organizations are not required to be located in New York; however, grant money must be used on programs that will benefit individuals in New York City and surrounding community. Preference will be given to new or existing programs working toward the shared colorectal cancer screening goal of 80% by 2018.
Get creative. We are looking for out-of-the-box thinking that will:
Have a real impact on colorectal cancer screening rates.
Target messages to populations at risk for young-onset colorectal cancer.
Reach those who have an increased genetic risk for the disease.
Submit a completed Grant Results Summary following the completion of the project or no later than 12 months after receiving the grant funds, whichever comes first. The grant recipient will need to include specific details on how the grant money was used and the results of the program or related statistics as available (screening rates and behavior changes, etc.)
LGBT HealthLink and the National LGBT Cancer Network have partnered to begin developing best and promising practices throughout the cancer continuum for LGBT people.
We are asking for you to contribute your expertise and knowledge to this process by reviewing and adding to what the expert committee has developed. Comments are being collected through an easy online process. Just follow the link below.
Whether you are a Survivor/Community Member, Provider/Clinician, Researcher/Scientist, or Public Health/Government Professional – we want to hear from you. Help us build a one of its kind resource to better fight cancer in the LGBT community and save lives.
One last thing, please share this opportunity with your colleagues so they too can share their expertise and knowledge just like you will.
When thinking about cancer, many people react with fear, confusion, sadness, and anger. Anal cancer can provoke all of these thoughts, along with additional feelings of embarrassment, uneasiness, and a sense of stigma. As a result, the conversation about anal cancer is hidden in a place where the sun doesn’t shine.
Now, it’s time to shed our anxieties (and our pants) to face anal cancer head on.
The National LGBT Cancer Network in partnership with Tusk and Dagger is launching a campaign to raise awareness about anal cancer and create a directory of free/low cost LGBT-friendly anal cancer screening facilities across the country. We invite you to show your support by donating at bit.ly/BehindClosedDrawers or texting “UNDIES” to 41444. We then ask you to help spread the word about uncovering the truth about anal cancer by posting a photo of your underwear on social media and tagging it with#BehindClosedDrawers. We hope to use these photos to add a touch of levity to a subject that is difficult to talk about.
Tackling anal cancer is a natural fit for The National LGBT Cancer Network: while the incidence is relatively rare in the general population (about 1 in 500) it is up to 34x more prevalent in men who have sex with men, and increasingly annually.
The majority of anal cancer cases are caused by the human papilloma virus (HPV)
HPV can be transmitted through both protected and unprotected anal intercourse and skin-to-skin contact, including manual stimulation
HIV-positive men with a history of anal intercourse are at the greatest risk for developing anal cancer; risk factors also include being a transplant recipient, a weakened immune system, smoking, and age
A growing number of physicians and health activists recommend that all men who have sex with men, especially those who are HIV+, be tested every 1-3 years depending on their immunological well-being and CD4 count. They suggest that HIV negative individuals be screened every 3 years.
This work is important, because most people know little about anal cancer, have never been screened for it, and don’t know that screening tests exist.
In October, Michael Bare wrote the post Increasing LGBT HPV vaccines for our blog, and revealed the disturbing statistic that only about 31% of lesbians and bisexual women who were interviewed had completed the 3-shot course of the HPV vaccine, while about 14% had started but not completed the vaccine series. Michael wrote “This is particularly concerning considering lesbians and bisexual women are less likely to get regular PAP tests which can lead to early detection, meaning any cancer diagnosis may come at a later stage in the illness.” In November, the CDC has come out with a series of new infographics illustrating important information about cervical cancer and HPV awareness.
Lesbians and cervical cancer
Compared to heterosexual women, lesbians may be at greater risk for HPV and cervical cancer due to health and lifestyle factors associated with poor overall health. Women who have sex with women can contract the virus from an infected partner in the same ways heterosexual women can, including through genital to genital contact, touching the genitals of a partner and then one’s own, or sharing sex toys without cleaning them properly first. Many lesbians have also experienced heterosexual intercourse, increasing their risk for HPV. However, lesbians are less likely to regularly visit a reproductive health specialist and are therefore less exposed to information about HPV or make use of the preventative steps developed for women. (Source: National LGBT Cancer Network)
Read more about HPV and cancer in LGBT communities HERE
Much of the work now being done in the health arena around HPV is to reframe the discussion from instead of viewing HPV only as an STI, to instead address the instead address it as a cause of cervical cancer, and to the lack of education, knowledge, and vaccination from that perspective.
(Read more about preventing cervical cancer on the CDC website HERE)
Additionally, the widespread misinformation about HPV transmission and lack of access to preventative care in LBT communities must be addressed. Culturally competent clinicians, as well as community outreach campaigns, are two ways to increase testing and awareness in our communities.
Michael G. Bare, MPH
National LGBT Cancer Network
The Human Papillomavirus (HPV) is the most common STI, and the cause of both lesions (warts) in the pelvic/ genital region, as well as the mouth. HPV has been found to be the cause of a variety of cancers. National Cancer Institute states that “high-risk HPVs cause virtually all cervical cancers. They also cause most anal cancers and some vaginal, vulvar, penile, and oropharyngeal cancers.”
The HPV vaccine was available for human use in 2006, and roll out campaigns aimed at youth have been the primary focus of the US public health service. In the US, the CDC suggests the HPV vaccine be given to all children 11-12 years old, teenagers who have not yet been vaccinated, for women up to age of 26 and for men up to age 21.
So what is the current uptake of the vaccine in LGBT communities? A study found that only about 31% of lesbians and bisexual women who were interviewed had completed the 3-shot course of the HPV vaccine, while about 14% had started but not completed the vaccine series; this is particularly concerning considering lesbians and bisexual women are less likely to get regular PAP tests which can lead to early detection, meaning any cancer diagnosis may come at a later stage in the illness. Rates for gay and bisexual men, and transgendered people are not available.
New research has shown that the HPV vaccine would be a good idea for adult gay and bisexual men, especially those living with HIV, which can increase the odds of cancer caused by HPV. For gay and bisexual men, HPV “is estimated to be present in 65% of gay men without HIV and 95% of those who are HIV positive. A simple and inexpensive anal Pap test detects the virus but, unfortunately, few physicians are performing anal screening exams and offering anal pap smears to gay men, resulting in anal cancer rates as high as those of cervical cancer BEFORE the use of routine Pap smears in women.” Activists in the UK are calling on the NHS to offer the vaccine to gay and bisexual men, calling current policies homophobic. Bisexuals, both men and women, have generally worse outcomes of most illnesses, compared to gay men and lesbians, and there is some evidence this extends to cancer. In our communities transgender folks may be uncomfortable, or cannot find a trans affirmative provider, who can perform necessary screenings such as prostate and rectal exams for trans women and chest and pelvic exams for trans men, which can also lead to late diagnosis and more invasive treatments.
While there is limited to no information on HPV vaccination rates for gay and bisexual men, or transgender persons, we recommend everyone seeking out the HPV vaccine from their provider. We also need better community messaging campaigns that bring information on this health issue to our community. The recent meningitis scare in LA and NYC has prompted public health officials to react, but HPV-related cancer will not have the same timing or geographical density for people to conceive an outbreak; these cancers will occur individually, across time: we need a similar high-yield campaign for HPV vaccines for the LGBT community.
Michael G. Bare, MPH
National LGBT Cancer Network
Do LGBT youth have higher prevalence of cancer than other youth? To be honest, we don’t know. The lack of sexual orientation and gender identity (SOGI) on institutional intake forms across the medical professions has resulted in difficulty ascertaining LGBT health disparities, requiring researchers to establish studies to answer these sorts of questions. SOGI is also not recorded in cancer registries. What we do know is that LGBT adults do have higher cancer rates, and higher prevalence of cancer risk factors, many of which may be traced back to experiences and behaviors that began in adolescents. Recently, the head of the U.S. food and drug administration stated that smoking is a pediatric disease, because the majority of adult smokers started in adolescents and adolescents who reach adulthood without ever having smoked a cigarette have much lower rates of starting cigarette use later in life. I would argue that many LGBT health disparities, including cancer, may be traced to minority stress and behaviors linked to this form of stress as coping mechanisms. In fact one study, Dr. Rosario (who worked on the study) commented “Sexual minorities are at risk for cancer later in life, I suggest, from a host of behaviors that begin relatively early in life,” said Professor Rosario. “No sex or ethnic racial group is at greater risk or protected for these behaviors. Overall, the study underscores the need for early interventions.” (1)
Minority stress is a public health theory which explains that stress resulting from discrimination and stigmatization of minority groups affects the individuals health in a number of ways throughout the lifespan. Many studies of minority stress show that LGBT people experience this, which may be further compounded by racial minority status, disability, class or many other stigmatized identities an individual may hold while also being LGBT. Earlier this year a study found that LGB people who live in communities with high levels of anti-LGB prejudice had a 12 year reduction in life expectancy when compared to heterosexual peers in the same community who do not experience discrimination (2). In 2013 other studies found that LGB people who live in states without LGBT protective policies were 5X more likely than those in other states to have 2 or more mental disorders (3) and LGB people who experienced “prejudice-related major life events” were 3x more likely to suffer a serious physical health problem over the next year than people who had not experienced such events regardless of other factors such as age, gender, employment and health history (4).
So how does this play out for LGBT youth specifically? One study found that, when asked about concerns, heterosexual high school students stated grades and classes as number 1 on their list, with college and careers, and financial pressures related to college or jobs coming second and third, while LGBT students reported more immediate, tangible issues such as non-accepting families, school bullying and fear of being out as their top 3 concerns (in that order) (5). We also know how stigma and discrimination leads to negative mental health outcomes. So, it is no surprise that mental health issues such as stress, depression and anxiety lead to higher levels of smoking, alcohol consumption, substance abuse and riskier sexual behavior. One study found that LGBT students had higher prevalence in 10 risk categories (these were: behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management) (6). The same study Dr. Rosario commented on earlier found that of “the 12 cancer-risk behaviors included tobacco use, drinking alcohol, early sex, multiple sexual partners, higher body mass index (BMI) and lack of exercise. The report found that for all 12, sexual minorities were more likely than heterosexuals to engage in the risky behavior (1). Other studies have linked psychological distress and LGBT victimization to high smoking prevalences (6).
So, while there is limited data on cancer among LGBT youth, it is clear that lifetime stressors related to LGBT status, instilled in adolescence, coupled with unhealthy coping mechanisms, are responsible for increased cancer incidence among LGBT adults. It is my opinion that the roots of these cancers may be traced to experiences of homophobia as a LGBT pediatric health disparity.
Rosario, M., Corliss, H. L., Everett, B. G., Reisner, S. L., Austin, S. B., Buchting, F. O., & Birkett, M. (2014). Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled Youth Risk Behavior Surveys. American journal of public health, 104(2), 245-254.
Haas AP, Eliason M, Mays VM, et al. Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of homosexuality. 2011;58(1):10-51.
Durso, L. E., & Meyer, I. H. (2013). Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals. Sexuality Research and Social Policy, 10(1), 35-42.
6.Kann, L., O’Malley Olsen, E., McManus, T., Kinchen, S., Chyen, D., Harris, W. A., & Wechsler, H. (2011). Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors among Students in Grades 9-12–Youth Risk Behavior Surveillance, Selected Sites, United States, 2001-2009. Morbidity and Mortality Weekly Report. Early Release. Volume 60. Centers for Disease Control and Prevention.