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Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States.
JAMA Dermatol. 2020 04 01; 156(4):441-445.JD

Abstract

Importance

Sexual minority men have reported higher rates of both indoor tanning and skin cancer than heterosexual men, and sexual minority women have reported lower or equal rates of both indoor tanning and skin cancer compared with heterosexual women. Bisexual men, in particular, have reported higher rates of indoor tanning bed use than heterosexual men; however, no study has investigated skin cancer prevalence among gay, lesbian, and bisexual individuals as separate groups.

Objective

To evaluate the association between sexual orientation and lifetime prevalence of skin cancer.

Design, Setting, and Participants

This cross-sectional study analyzed data from the 2014-2018 Behavioral Risk Factor Surveillance System (BRFSS) surveys of a noninstitutionalized population in the United States that included 877 650 adult participants who self-identified as being heterosexual, gay, lesbian, or bisexual.

Main Outcomes and Measures

Self-reported lifetime history of skin cancer.

Results

The study included 877 650 participants, including 364 833 heterosexual men (mean age, 47.7; 95% CI, 47.5-47.8), 7823 gay men (mean age, 42.7; 95% CI, 41.8-43.6), 5277 bisexual men (mean age, 39.4; 95% CI, 38.4-40.5), 484 341 heterosexual women (mean age, 49.7; 95% CI, 49.6-49.8), 5609 lesbian women (mean age, 41.8; 95% CI, 40.6-43.0), and 9767 bisexual women (mean age, 32.8; 95% CI, 32.3-33.3). The adjusted odds ratios (AORs) of skin cancer prevalence were significantly higher among both gay (AOR, 1.25; 95% CI, 1.03-1.50; P = .02) and bisexual men (AOR, 1.46; 95% CI, 1.01-2.10; P = .04) compared with heterosexual men. The AORs of skin cancer were statistically significantly lower among bisexual women (AOR, 0.75; 95% CI, 0.60-0.95; P = .02) but not among gay or lesbian women (AOR, 1.01; 95% CI, 0.77-1.33; P = .95) compared with the AORs of skin cancer among heterosexual women.

Conclusions and Relevance

In this study, gay and bisexual men had an increased self-reported lifetime prevalence of skin cancer compared with the prevalence among heterosexual men. Patient education and community outreach initiatives focused on reducing skin cancer risk behaviors among gay and bisexual men may help reduce the lifetime development of skin cancer in this population. Continued implementation of the Behavioral Risk Factor Surveillance System's sexual orientation and gender identity module is imperative to improve understanding of the health and well-being of sexual minority populations.

Authors+Show Affiliations

Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. University of Massachusetts Medical School, Worcester.Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Dermatology, Veterans Integrated Service Network, Jamaica Plain, Massachusetts.Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Associate Editor.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32049301

Citation

Singer, Sean, et al. "Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States." JAMA Dermatology, vol. 156, no. 4, 2020, pp. 441-445.
Singer S, Tkachenko E, Hartman RI, et al. Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States. JAMA Dermatol. 2020;156(4):441-445.
Singer, S., Tkachenko, E., Hartman, R. I., & Mostaghimi, A. (2020). Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States. JAMA Dermatology, 156(4), 441-445. https://doi.org/10.1001/jamadermatol.2019.4196
Singer S, et al. Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States. JAMA Dermatol. 2020 04 1;156(4):441-445. PubMed PMID: 32049301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States. AU - Singer,Sean, AU - Tkachenko,Elizabeth, AU - Hartman,Rebecca I, AU - Mostaghimi,Arash, PY - 2020/2/13/pubmed PY - 2020/12/30/medline PY - 2020/2/13/entrez SP - 441 EP - 445 JF - JAMA dermatology JO - JAMA Dermatol VL - 156 IS - 4 N2 - Importance: Sexual minority men have reported higher rates of both indoor tanning and skin cancer than heterosexual men, and sexual minority women have reported lower or equal rates of both indoor tanning and skin cancer compared with heterosexual women. Bisexual men, in particular, have reported higher rates of indoor tanning bed use than heterosexual men; however, no study has investigated skin cancer prevalence among gay, lesbian, and bisexual individuals as separate groups. Objective: To evaluate the association between sexual orientation and lifetime prevalence of skin cancer. Design, Setting, and Participants: This cross-sectional study analyzed data from the 2014-2018 Behavioral Risk Factor Surveillance System (BRFSS) surveys of a noninstitutionalized population in the United States that included 877 650 adult participants who self-identified as being heterosexual, gay, lesbian, or bisexual. Main Outcomes and Measures: Self-reported lifetime history of skin cancer. Results: The study included 877 650 participants, including 364 833 heterosexual men (mean age, 47.7; 95% CI, 47.5-47.8), 7823 gay men (mean age, 42.7; 95% CI, 41.8-43.6), 5277 bisexual men (mean age, 39.4; 95% CI, 38.4-40.5), 484 341 heterosexual women (mean age, 49.7; 95% CI, 49.6-49.8), 5609 lesbian women (mean age, 41.8; 95% CI, 40.6-43.0), and 9767 bisexual women (mean age, 32.8; 95% CI, 32.3-33.3). The adjusted odds ratios (AORs) of skin cancer prevalence were significantly higher among both gay (AOR, 1.25; 95% CI, 1.03-1.50; P = .02) and bisexual men (AOR, 1.46; 95% CI, 1.01-2.10; P = .04) compared with heterosexual men. The AORs of skin cancer were statistically significantly lower among bisexual women (AOR, 0.75; 95% CI, 0.60-0.95; P = .02) but not among gay or lesbian women (AOR, 1.01; 95% CI, 0.77-1.33; P = .95) compared with the AORs of skin cancer among heterosexual women. Conclusions and Relevance: In this study, gay and bisexual men had an increased self-reported lifetime prevalence of skin cancer compared with the prevalence among heterosexual men. Patient education and community outreach initiatives focused on reducing skin cancer risk behaviors among gay and bisexual men may help reduce the lifetime development of skin cancer in this population. Continued implementation of the Behavioral Risk Factor Surveillance System's sexual orientation and gender identity module is imperative to improve understanding of the health and well-being of sexual minority populations. SN - 2168-6084 UR - https://www.unboundmedicine.com/medline/citation/32049301/Association_Between_Sexual_Orientation_and_Lifetime_Prevalence_of_Skin_Cancer_in_the_United_States_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2019.4196 DB - PRIME DP - Unbound Medicine ER -