Key PointsQuestion听
Does the association between sexual orientation and lifetime prevalence of skin cancer differ across racial and ethnic groups among US adult females and males?
Findings听
In this cross-sectional study of 1鈥�512鈥�400 US adults, lifetime prevalence of skin cancer was higher among Hispanic and non-Hispanic Black sexual minority (SM) males compared with their heterosexual counterparts. Lifetime prevalence of skin cancer was lower among non-Hispanic White SM females but higher among Hispanic and non-Hispanic Black SM females compared with their heterosexual counterparts.
Meaning听
In this study, differences in lifetime prevalence of skin cancer among SM adults compared with heterosexual adults varied across race and ethnicity among females and males.
Importance听
Sexual minority (SM) persons have been found to have differential rates of skin cancer, but limited data exist on differences across racial and ethnic groups and by individual sexual identities.
Objective听
To examine differences by sexual orientation in the lifetime prevalence of skin cancer among US adult females and males across racial and ethnic groups and by individual sexual identity.
Design, Setting, and Participants听
This cross-sectional study used data from the Behavioral Risk Factor Surveillance System from January 1, 2014, to December 31, 2021, for US adults from the general population. Data were analyzed from December 1, 2023, to March 1, 2024.
Main Outcomes and Measures听
Self-reported lifetime prevalence of skin cancer by sexual orientation. Age-adjusted prevalence and adjusted prevalence odds ratios (AORs) compared heterosexual and SM adults in analyses stratified by individual race.
Results听
Of 1鈥�512鈥�400 participants studied, 805鈥�161 (53.2%) were heterosexual females; 38鈥�933 (2.6%), SM females; 638鈥�651 (42.2%), heterosexual males; and 29鈥�655 (2.0%), SM males. A total of 6.6% of participants were Hispanic; 3.4%, non-Hispanic Asian, Pacific Islander, or Hawaiian; 7.5%, non-Hispanic Black; 78.2%, non-Hispanic White; and 4.3%, other race and ethnicity. Mean (SE) age was 48.5 (0.03) years (incomplete data for age of respondents 鈮�80 years). The lifetime prevalence of skin cancer was overall higher among SM males compared with heterosexual males (7.4% vs 6.8%; AOR, 1.16; 95% CI, 1.02-1.33), including specifically among Hispanic males (4.0% vs 1.6%; AOR, 3.81; 95% CI, 1.96-7.41) and non-Hispanic Black males (1.0% vs 0.5%; AOR, 2.18; 95% CI, 1.13-4.19) in analyses stratified by race and ethnicity. Lifetime prevalence rates were lower among SM females compared with heterosexual females among non-Hispanic White females (7.8% vs 8.5%; AOR, 0.86; 95% CI, 0.76-0.97) and were higher among Hispanic (2.1% vs 1.8%; AOR, 2.46; 95% CI, 1.28-4.70) and non-Hispanic Black (1.8% vs 0.5%; AOR, 2.33; 95% CI, 1.01-5.54) females in analyses stratified by race and ethnicity.
Conclusions and Relevance听
In this cross-sectional study of US adults, differences in the lifetime prevalence of skin cancer among SM adults compared with heterosexual adults differed across racial and ethnic groups and by individual sexual identity among both females and males. Both Hispanic and non-Hispanic Black and SM females and males had higher rates of skin cancer compared with their heterosexual counterparts. Further research addressing the individual factors contributing to these differences is needed to inform screening guidelines and public health interventions focused on these diverse, heterogeneous populations.