Lifetime prevalence of skin cancer higher in gay, bisexual men

Self-reported lifetime prevalence of skin cancer was higher in gay and bisexual men compared with heterosexual men, according to a cross-sectional study published in JAMA Dermatology.

“We found that the rates of skin cancer were 8.1% among gay men and 8.4% among bisexual men, statistically higher than the rate of 6.7% among heterosexual men. Skin cancer rates were 5.9% among lesbian women and 6.6% among heterosexual women, which was not a statistically significant difference,” Arash Mostaghimi, MD, MPA, MPH, assistant professor of dermatology at Harvard Medical School and director of inpatient consultation service, department of dermatology, at Brigham and Women’s Hospital, told Healio. “However, the rate of 4.7% among bisexual women was statistically significantly lower than heterosexual women.”

Researchers analyzed the Behavioral Risk Factor Surveillance System (BRFSS) annual questionnaires from 2014 to 2018. Sexual orientation was self-reported in the sexual orientation and gender identity (SOGI) module. Of the 845,264 people included in the study, 7,516 identified as gay men, 5,392 as gay or lesbian women, 5,088 as bisexual men, 9,445 as bisexual women, 351,468 as heterosexual men and 466,355 as heterosexual women.

The age-adjusted lifetime prevalence of skin cancer was 8.1% among gay men, 8.4% among bisexual men and 6.7% among heterosexual men. Gay men (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) had statistically significantly higher odds of a skin cancer diagnosis compared with heterosexual men.

For women, the age-adjusted lifetime prevalence of skin cancer was 5.9% among lesbians, 4.7% among bisexual women and 6.6% among heterosexual women. Bisexual women (AOR = 0.78; 95% CI, 0.61-0.99; P = .04) had statistically significantly lower odds of a skin cancer diagnosis compared with heterosexual women, but gay or lesbian women did not (AOR = 0.97; 95% CI, 0.73-1.27).

“Future work needs to identify the core drivers of this increased risk for skin cancer among gay and bisexual men,” Mostaghimi said. “Once we identify the reasons behind these trends, we can generate public health interventions to improve outcomes in this population. It’s critical that we continue to study sexual and gender identity as part of the BRFSS and other ongoing federal research initiatives to understand the health and well-being of sexual minorities.”

The data examined in this study should not be taken for granted because key demographic variables relevant to sexual and gender minority persons have historically not been collected, according to an accompanying editorial by Howa Yeung, MD, MSc, of the department of dermatology at Emory University School of Medicine in Atlanta and Regional Telehealth Service at VA Southeast Network in Decatur, Georgia, and colleagues.

“Despite stated U.S. national priorities, skin diseases have remained largely hidden from existing research on [sexual and gender minority] health,” they wrote.

Dermatologists should collect SOGI data during routine clinical visits, investigate potential differences in dermatology-related outcomes and collaborate across all disciplines to advocate for dermatology-related outcomes to be included in ongoing and future sexual and gender minority health studies, the editorial authors said. – by Erin T. Welsh

Disclosures: Mostaghimi reports receiving personal fees from Pfizer, Hims and 3Derm and equity from Hims and Lucid, and performing clinical trials from Eli Lily and Company, Aclaris Therapeutics and Concert Pharmaceuticals outside the submitted work. Yeung reports receiving honorarium from Syneos Health and support from the National Center for Advancing Translational Sciences of the National Institutes of Health. Please see the reports for all other authors’ relevant financial disclosures.