Is There a Link Between Cancer and Poppers in Gay Men?

New findings published in the journal AIDS show that daily or weekly use of poppers over a number of years might be associated to an increase in the risk of cancers for HIV-negative men who have sex men between the ages 50 and 70.

While there have been claims that poppers (or nitrate inhalants) might interfere with viral suppression in HIV-positive people, numerous studies have proven them to be false.

In fact, AIDS Map reports animal models show that while poppers can cause transient immunosuppression (where it may be suppressed for a short period of time), they are not linked to long-term immunosuppression in gay men with HIV or to the development of Kaposi’s sarcoma, the most common AIDS-defining cancer.

The real concerns lie in the cancer risks associated with frequent use, such as HPV.

One particular study by the Multicenter AIDS Cohort Study investigated the relationship between the use of poppers and cancer. Researchers divided 3,223 male participants (1,563 of whom were HIV-positive, and 1,660 of whom were not) into three groups: heavy users, light users, and non-users.

Heavy use was classified as daily or weekly, light use was classified as monthly or less, and non-users were classified as none.

Researchers compared heavy users to a controlled group of both light and non-users. Turns out, the 20 percent of HIV-negative men and 33 percent of HIV-positive men who were classified as heavy poppers users had no significant difference in their immune system when compared to light and non-users.

These results weren’t very surprising. However, when it came to the topic of various types of cancers, it was a different story.

Overall, 327 different types of cancers were diagnosed in 296 participants. Non-Hodgkin lymphoma, squamous cell carcinoma of the skin, prostate cancer, and other cancers were high in the group of heavy users.

And for HIV-positive men, the risk of virus-associate cancers — such as non-Hodgkin lymphoma, Hodgkin lymphoma (caused by EBV), Kaposi’s sarcoma (HHV-8) and anal and oropharyngeal cancer (HPV) — were much more common than the rest of the population.

Another interesting discovery was that men between 50 and 70 were three times more likely to be diagnosed with a virus-associated cancer. They also made a higher proportion of the total burden of cancers.

It was estimated that the greater the use of poppers over the first five years after enrolment, the higher the risk of virus-associated cancers in HIV-negative men between 50 and 70, reportsAIDS Map.

Hepatitis B or hepatitis C were not included in the categories of virus-associated cancers. 

Poppers are mainly used as a sexual enhancer, and have a word-of-mouth appeal to gay and bi men, many of whom say it helps with bottoming. According to the Health Professionals Data Sheet, inhaling amyl nitrite causes a non-specific relaxation of smooth muscle, which can be found in the sphincter of the anus.

While it’s difficult to map out correct statistics, present studies suggest that around 3 percent of the U.S. population use poppers. The most common minor side effects have been listed as headaches, loss of erection during sex, sweating and mild congestion. 

 Of course, many remember the popularity and hysteria over poppers in the 1980s: During the early days of the AIDS epidemic when poppers were thought to be the cause of the disease that was then called "gay cancer." Now we know it's HIV. It's a reminder that initial studies need to be augmented, and in this case to determine causal links between poppers and cancer in HIV-negative men.