Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
University of Massachusetts Medical School, Worcester.
JAMA Dermatol. 2020 Apr 1;156(4):441-445. doi: 10.1001/jamadermatol.2019.4196.
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.
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.
Self-reported lifetime history of skin cancer.
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.
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.
与异性恋男性相比，性少数群体男性报告的室内晒黑和皮肤癌发病率更高，而性少数群体女性报告的室内晒黑和皮肤癌发病率则更低或与异性恋女性相同。特别是双性恋男性报告的使用室内晒黑床的比率高于异性恋男性；然而，尚无研究调查同性恋、双性恋和双性恋个体作为单独群体的皮肤癌患病率。
评估性取向与皮肤癌终身患病率之间的关联。
设计、地点和参与者：这项横断面研究分析了美国 2014-2018 年行为风险因素监测系统（BRFSS）调查的非住院人群数据，该调查包括 877650 名自认为是异性恋、同性恋、女同性恋或双性恋的成年参与者。
自我报告的皮肤癌终身史。
该研究纳入了 877650 名参与者，其中包括 364833 名异性恋男性（平均年龄 47.7；95%CI，47.5-47.8）、7823 名同性恋男性（平均年龄 42.7；95%CI，41.8-43.6）、5277 名双性恋男性（平均年龄 39.4；95%CI，38.4-40.5）、484341 名异性恋女性（平均年龄 49.7；95%CI，49.6-49.8）、5609 名女同性恋女性（平均年龄 41.8；95%CI，40.6-43.0）和 9767 名双性恋女性（平均年龄 32.8；95%CI，32.3-33.3）。同性恋男性（调整后的优势比，AOR，1.25；95%置信区间，1.03-1.50；P=0.02）和双性恋男性（AOR，1.46；95%CI，1.01-2.10；P=0.04）的皮肤癌患病率显著高于异性恋男性。与异性恋女性相比，双性恋女性的皮肤癌 AOR 统计学上显著降低（AOR，0.75；95%CI，0.60-0.95；P=0.02），而同性恋或女同性恋女性的皮肤癌 AOR 则没有统计学差异（AOR，1.01；95%CI，0.77-1.33；P=0.95）。
在这项研究中，与异性恋男性相比，同性恋和双性恋男性的自我报告的皮肤癌终身患病率更高。针对减少男同性恋和双性恋男性皮肤癌风险行为的患者教育和社区外展计划，可能有助于减少该人群皮肤癌的终身发展。继续实施行为风险因素监测系统的性取向和性别认同模块对于提高对性少数群体健康和福祉的理解至关重要。
