Photo Credit: Nadzeya Haroshka

Lifetime skin cancer prevalence among sexual minority adults compared with heterosexual adults varied across racial and ethnic groups and sexual orientation.

Lifetime skin cancer prevalence among sexual minority adults compared with heterosexual adults varied across racial and ethnic groups and sexual orientation, according to research from a large cross-sectional study published in JAMA Dermatology.

“While the effect size of some associations was modest, these findings may have important implications for population-based research and public health efforts aimed at early detection and prevention of skin cancer among US adults,” Matthew Mansh, MD, and colleagues wrote.

Using data of adults in the US general population from the Behavioral Risk Factor Surveillance System from January 2014 to December 2021, the researchers included 1,512,400 patients—805,161 heterosexual women, 38,933 sexual minority women, 638,651 heterosexual men, and 29,655 sexual minority men. Of the study patients, the proportions of sexual minority women and men (who self-identified as bisexual, lesbian, gay, something else, or other) were 2.6% and 2.0%, respectively.

Overall, lifetime skin cancer prevalence was higher among sexual minority men compared with heterosexual men (7.4% vs 6.8%; adjusted odds ratio [AOR], 1.16). Among women, the researchers reported the overall prevalence did not differ by sexual orientation.

In an analysis stratified by racial and ethnic group, the prevalence rates among sexual minority men versus their heterosexual counterparts were higher only among Black (1.0 vs 0.5%; AOR, 2.18) and Hispanic (4.0% vs 1.6%; AOR, 3.81) men. Compared with heterosexual women, lifetime prevalence rates were higher for non-Hispanic Black (1.8% vs 0.5%; AOR, 2.33) and Hispanic (2.1% vs 1.8%; AOR, 2.46) sexual minority women.

In a secondary analysis that combined all minority people along gender lines, the findings showed lifetime skin cancer prevalence was higher in bisexual men (AOR, 3.94), bisexual women (AOR, 1.51), and women identifying as something else or other (AOR, 2.70).

The researchers highlighted factors that may explain the findings. Ultraviolet radiation risk behaviors across identities among sexual minority people could be linked with skin cancer prevalence in these diverse populations. Limited healthcare access, coverage, and financial limitations among bisexual women may influence their awareness and behaviors associated with skin cancer risk factors.

“Future research and public health interventions should consider race and ethnicity and individual sexual identity when addressing skin cancer and related risk behaviors, with a particular emphasis on Black and Hispanic SM [sexual minority] females and males and White gay males,” concluded the researchers. “Such efforts may help inform screening guidelines and primary prevention efforts aimed at reducing rates of skin cancer among all people.”