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

Abstract

Background: Colorectal cancer (CRC) screening can reduce CRC risk, yet many men are not up to date with screening guidelines. While previous qualitative studies have suggested links among anti-gay prejudice, traditional masculine self-concept, racial identity, and CRC 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 US to test these associations and examine the sociodemographic correlates.

Methods: Using the NORC/AmeriSpeak probability-based panel, we recruited a sample of Black and White men in the US aged 45 to 74 who had never been diagnosed with CRC (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 CRC screening test options and less likely to intend to engage in CRC screening. Results have implications for the design and development of future interventions aimed at increasing CRC 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 CRC screening.