The Reliability of Self-Reported Gleason Scores in Studies of Sexual Minority Prostate Cancer Survivors

In two studies, gay, bisexual, and other men who have sex with men prostate cancer survivors report lower Gleason scores than heterosexual prostate cancer survivors, leading some to speculate that men who have sex with men may have more intensive screening than other men. In the largest study of men who have sex with men prostate cancer survivors to date, 23 of 193 (11.9%) men who have sex with men prostate cancer survivors reported low Gleason scores (2-5). We contacted 14 of them, a 61 percent response rate. At second interview, most men clarified that they reported only a partial score rather than the sum score. We conclude the average lower score is not a result of differences in screening but likely measurement error. A revised Gleason item question is provided to overcome this research artifact.