Gay and bisexual men were up to six times more likely than heterosexual men to take part in indoor tanning, and twice as likely to report a history of skin cancer, including nonmelanoma and melanoma, according to a study led by UC San Francisco researchers.
Conversely, gay and bisexual women were half as likely as heterosexual women to report both indoor tanning and non-melanoma skin cancer, according to the study, led by Sarah Arron, MD, PhD, a UCSF associate professor of dermatology.
The data analysis of 192,575 adult men and women - 66,677 in California and 125,898 from a national survey -- will be published October 7, 2015 in JAMA Dermatology.
The difference in skin cancer rates persisted even after the researchers controlled for a history of immunosuppression, including HIV infection status.
"One likely cause of more skin cancer among gay and bisexual men is greater exposure to ultraviolet radiation caused by indoor tanning," said Arron, who also directs the UCSF High Risk Cancer Program. "Many people, especially younger people, associate tanning with health and attractiveness, and unfortunately, that myth has serious consequences."
Arron noted that skin cancer is the most common cancer in the United States, with about five million Americans treated annually at a cost of $8.1 billion. Identified as a major public health problem by the U.S. Surgeon General, it is increasing at a rate of about 4 percent per year. One preventable risk factor is ultraviolet exposure from indoor and outdoor tanning.
While data on outdoor tanning were unavailable, the authors cited previous studies showing that indoor tanners are also more likely to engage in outdoor tanning.
"Our hope is that this finding will help increase awareness among health care providers that gay and bisexual men constitute a high-risk population for skin cancer, which in turn will lead to increased public health education and more diligent skin cancer screening in this group of men," Arron said. "Recent research suggests that, fortunately, screening can increase early detection and decrease mortality from this disease."
The authors used data from the 2001, 2003, 2005 and 2009 California Health Interview Surveys, conducted every two years by the UCLA Center for Health Policy Research, and the 2013 Adult National Health Interview Survey, which is conducted annually by the National Center for Health Statistics.
The study is the first to compare skin cancer rates between heterosexual men and gay and bisexual men, and the first to assess skin cancer rates and indoor tanning behavior by sexual orientation in women, said the authors.
Co-authors of the study are Matthew Mansh, MD, of UCSF and Stanford University; Eleni Linos, MD, DrPH, of UCSF; Mary-Margaret Chren, MD, of UCSF and the San Francisco VA Medical Center; and Kenneth A. Katz, MD, MSc, MSCE, of Kaiser Permanente.
The study was supported by funds from the Stanford Medical Scholars Research Grant, the National Center for Advancing Translational Sciences and the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
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