This cross-sectional study examines the association between sexual orientation and
self-reported lifetime prevalence of skin cancer in the United States among individuals
who have self-identified as being heterosexual or of a sexual minority population.
What is the association between sexual orientation and lifetime prevalence of skin
cancer in the United States? In this cross-sectional study of 845 264 adults, both
gay and bisexual men had higher adjusted odds of lifetime prevalence of skin cancer
compared with heterosexual men. Bisexual women, but not lesbian women, had lower odds
of lifetime prevalence of skin cancer compared with heterosexual women. Patient education
and community outreach programs targeting these populations may be helpful in reducing
disparities in lifetime skin cancer prevalence. 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. To evaluate the association between sexual orientation and lifetime
prevalence of skin cancer. 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 845 264 adult participants who self-identified
as being heterosexual, gay, lesbian, or bisexual. Self-reported lifetime history of
skin cancer. The study included 845 264 participants, including 351 468 heterosexual
men (mean age, 47.7; 95% CI, 47.5-47.8), 7516 gay men (mean age, 42.7; 95% CI, 41.9-43.5),
5088 bisexual men (mean age, 39.3; 95% CI, 38.2-40.4), 466 355 heterosexual women
(mean age, 49.7; 95% CI, 49.6-49.9), 5392 lesbian women (mean age, 41.9; 95% CI, 40.7-43.2),
and 9445 bisexual women (mean age, 32.7; 95% CI, 32.2-33.2). The adjusted odds ratios
(AORs) of skin cancer prevalence were significantly higher among both gay (AOR, 1.26;
95% CI, 1.05-1.51; P = .01) and bisexual men (AOR, 1.48; 95% CI, 1.02-2.16; P = .04)
compared with heterosexual men. The AORs of skin cancer were statistically significantly
lower among bisexual women (AOR, 0.78; 95% CI, 0.61-0.99; P = .04) but not among
gay or lesbian women (AOR, 0.97; 95% CI, 0.73-1.27; P = .81) compared with the AORs
of skin cancer among heterosexual women. 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.