Associations between Anti-Gay Prejudice, Traditional Masculine Self-Concept, and Colorectal Cancer Screening-Related Outcomes among Black and White Men in the United States.

Background: Colorectal cancer screening can reduce colorectal cancer risk, yet many men are not up to date with screening guidelines. Although previous qualitative studies have suggested links among anti-gay prejudice, traditional masculine self-concept, racial identity, and colorectal cancer screening among men, scholars have yet to fully explore these associations using quantitative data. This study used a nationally representative sample of Black and White men in the United States to test these associations and examine the sociodemographic correlates.

Methods: Using the National Opinion Research Center (NORC)/AmeriSpeak probability-based panel, we recruited a sample of Black and White men in the United States ages 45 to 74 years who had never been diagnosed with colorectal cancer (N = 909). Participants completed an online questionnaire measuring anti-gay prejudice, traditional masculine self-concept, sociodemographic variables, and screening-related outcomes (awareness of screening test options, screening intention, and adherence to screening recommendations).

Results: Black participants reported higher levels of anti-gay prejudice and traditional masculine self-concept than White participants. Anti-gay prejudice was associated with lower awareness and lower screening intention. Black participants reported higher intention to follow screening recommendations but not higher odds of actual adherence than White participants.

Conclusions: Men with anti-gay prejudice are less likely to be aware of colorectal cancer screening test options and less likely to intend to engage in colorectal cancer screening. The results have implications for the design and development of future interventions aimed at increasing colorectal cancer screening rates.

Impact: Future studies could develop targeted interventions and observe subsequent changes or conduct longitudinal studies to further explore the role of anti-gay prejudice in colorectal cancer screening.