Prostate-Specific Antigen Surveillance Rates in Sexual Minority Prostate Cancer Survivors During the COVID-19 Pandemic

While the coronavirus disease 2019 pandemic necessitated delays in nonurgent healthcare, the specific impact on sexual minority cancer patients has remained largely unexamined. In this cross-sectional observational subanalysis of the 24-month survey from the Restore-2 randomized controlled trial, we evaluated perceived delays in care and compliance with European Association of Urology (EAU) recommendations for prostate-specific antigen (PSA) follow-up among 217 gay and bisexual prostate cancer survivors. Data collected in 2021 via a 24-month survey revealed that while most participants did not perceive significant treatment delays due to the pandemic, approximately one-third (33.6%) were noncompliant with EAU PSA screening guidelines. Demographic characteristics associated with noncompliance included White race, non-Hispanic ethnicity, lower education levels, single relationship status, and bisexual identity. Conversely, patients seen by oncologists or radiation oncologists demonstrated lower rates of noncompliance compared to those followed by urologists or general practitioners. These findings suggest that sexual minority male survivors, particularly those identifying as bisexual, may face unique challenges in maintaining oncologic surveillance during periods of resource scarcity. Given that this cohort was disproportionately well-educated and engaged in rehabilitative care, these results may underestimate broader disparities in care delays. These data support the need for increased vigilance and structured follow-up plans to ensure equitable survivorship care during public health crises.