How relates lifetime prevalence of skin cancer to sexual orientation

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February 16, 2020 – An often asked question is whether there is an association between sexual orientation and lifetime prevalence of skin cancer. According to a cross-sectional study of 845’ 264 adults in the US, just published in JAMA Dermatology as recent as February 12, 2020, the answer to this question would be a sounding yes. Both gay and bisexual men had higher adjusted odds (see also odds-ratio in this context) of lifetime prevalence of skin cancer compared with heterosexual men. In contrast, bisexual women, but not lesbian women, had lower odds of lifetime prevalence of skin cancer compared with heterosexual women.
Particularly worrying seem the higher odds in gay and bisexual men for skin cancers when compared to heterosexuell men. The question arises if these groups of male individuals expose themselves knowingly or unknowingly to a higher degree of risk factors eventually leading to skin cancer than their heterosexuell counterparts.
In the present study, 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 were analyzed. Thus, the study included 845’ 264 participants, including 351’ 468 heterosexual men (mean age, 47.7; 95% CI, 47.5-47.8), 7’516 gay men (mean age, 42.7; 95% CI, 41.9-43.5), 5’088 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), 5’392 lesbian women (mean age, 41.9; 95% CI, 40.7-43.2), and 9’445 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. Thus, gay and bisexual men in this study had an increased self-reported lifetime prevalence of skin cancer compared with the prevalence among heterosexual men.
When it comes to identification of possible risk factors, then it is noteworthy that sexual minority men have self reported higher rates of both indoor tanning than heterosexual men, and sexual minority women have self reported lower or equal rates of indoor tanning 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.
Overall, sexual and gender minority (SGM) persons include, but are not limited to, individuals who identify as lesbian, gay, bisexual, or transgender, as well as individuals whose sexual orientation, gender identity or expression, or reproductive development are characterized by nonbinary constructs of sexual orientation, gender, and/or sex. Population-based data on skin cancer epidemiology in SGM persons remain inadequate. Without robust epidemiologic data, it is challenging for dermatologists to recognize and articulate their specific roles within broader national conversations on improving SGM health. Emerging skin cancer data, particularly among gay and bisexual men, as noted in the present study, indicate unmet needs for skin cancer prevention in specific SGM subpopulations. Moreover, 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.
It would also be interesting to know, which types of skin cancers are more prevalent in these populations. One could easily imagine that certain skin cancer types arise specifically in dependence of the underlying risk factors sexual minority populations expose themselves, tanning and increased tanning bed time just being one example in case.
See here a short sequence on types of skin cancers:

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About the Author
Joseph Gut - thasso Ph.D.; Professor in Pharmacology and Toxicology. Senior expert in theragenomic and personalized medicine and individualized drug safety. Senior expert in pharmaco- and toxicogenetics. Senior expert in human safety of drugs, chemicals, environmental pollutants, and dietary ingredients.

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