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Skin Cancer Risk Higher for Certain Sexual and Gender Minority Populations

Gender-non-confirming individuals and gay and bisexual men had a higher prevalence of skin cancer compared with heterosexual and cisgender men and women, according to the findings of 2 new studies.1,2 The 2 cross-sectional studies were published in JAMA Dermatology.

“Although the differences in prevalence estimates are small in absolute magnitude, these data provide additional concrete examples of disproportionate skin cancer burden within [sexual and gender minority] subpopulations,” said the authors of an editorial, also published in JAMA Dermatology.3

The Studies

Using data from the Behavioral Risk Factor Surveillance System surveys from 2014 to 2018, Singer et al1,2 calculated the adjusted odds ratio (AOR) of reported history of skin cancer. The first study included 7516 gay men, 5088 bisexual men, 351,468 heterosexual men, 5392 lesbian women, 9445 bisexual women, and 466,355 heterosexual women. The second study included 368,197 cisgender men, 492,345 cisgender women, 1214 transgender men, 1675 transgender women, and 766 gender non-confirming individuals.
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In the first study, Singer et al1 found the AOR for the prevalence of skin cancer was significantly higher among both gay (1.26; 95% CI, 1.05-1.51) and bisexual men (1.48; 95% CI, 1.02-2.16) compared with heterosexual men. The AOR of skin cancer among bisexual women was statistically significantly lower among bisexual women compared with heterosexual women (0.78; 95% CI, 0.61-0.99), but was not lower among gay or lesbian women (0.97; 95% CI, 0.73-1.27).

In the second study, Singer et al2 found that the age-adjusted lifetime prevalence of skin cancer was 6.6% among cisgender men, 6.4% among cisgender women, 6% among transgender men, 5.8% among transgender women, and 7.1% among gender-non-conforming individuals. Compared with cisgender men, the AORs of skin cancer history were significantly lower among cisgender women (0.85%; 95% CI, 0.82-0.88), but not significantly different among transgender men or transgender women, and higher among gender-non-conforming individuals (2.11; 95% CI, 1.01-4.39).

Conclusion and Future Research

Both studies highlighted subpopulations that may need more intensive sun protective counseling. Gay and bisexual men had an increased self-reported lifetime prevalence of skin cancer, as did gender-non-confirming individuals.

While additional studies are needed to confirm these findings, Singer et al noted the need for patient education and community outreach initiatives to reduce skin cancer risk behaviors in sexual and gender minority communities.

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,” they added.

“It is time for dermatologists to lend their expertise to help prioritize the dermatology-related health of [sexual and gender minority] persons,” the authors of the editorial wrote.3

References

1. Singer S, Tkachenko E, Hartman RI, Mostaghimi A. Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States [published online February 12, 2020]. JAMA Dermatol. doi:10.1001/jamadermatol.2019.4196

2. Singer S, Tkachenko E, Hartman RI, Mostaghimi A. Gender Identity and Lifetime Prevalence of Skin Cancer in the United States [published online February 12, 2020]. JAMA Dermatol. doi:10.1001/jamadermatol.2019.4197

3. Yeung H, Braun H, Goodman M. Sexual and Gender Minority Populations and Skin Cancer—New Data and Renewed Priorities [published online February 12, 2020. JAMA Dermatol. doi:10.1001/jamadermatol.2019.4174

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