News Release 

Gay and bisexual men have higher rate of skin cancer

Comprehensive study compares prevalence to heterosexual men; bisexual women have lower rate of skin cancer than heterosexual women

Brigham and Women's Hospital

Boston, MA -- In the largest study of skin cancer rates among gay, lesbian or bisexual individuals, investigators from Brigham and Women's Hospital report important differences in skin cancer prevalence among sexual minorities. Rates of skin cancer were higher among gay and bisexual men compared to heterosexual men but lower among bisexual women than heterosexual women. These findings, which were possible because of the sexual orientation and gender identity (SOGI) module built into a national system of surveys, have implications for patient education and community outreach initiatives focused on reducing skin cancer risk. They also have implications for the design of future nationwide surveys. Results are published in JAMA Dermatology.

"It's absolutely critical that we ask about sexual orientation and gender identity in national health surveys; if we never ask the question, we'd never know that these differences exist," said corresponding author Arash Mostaghimi, MD, MPA, MPH, director of the Dermatology Inpatient Service at the Brigham. "This information helps inform the nation about how to allocate health resources and how to train providers and leaders. When we look at disparities, it may be uncomfortable, but we need to continue to ask these questions to see if we're getting better or worse at addressing them. Historically, this kind of health variation was hidden, but we now recognize that it's clinically meaningful."

Mostaghimi and colleagues leveraged data from the Behavioral Risk Factor Surveillance System (BRFSS), using data collected from annual questionnaires from 2014 to 2018. The Centers for Disease Control (CDC) uses the BRFSS to collect information about risk factors and behaviors among adults. About 450,000 adults are interviewed by telephone by the BRFSS each year. Beginning in 2014, the BRFSS began using the SOGI module to include questions about sexual orientation and gender identity. This module was administered in 37 states.

Mostaghimi and colleagues compared skin cancer rates among heterosexual men to rates in gay or bisexual men and compared rates among heterosexual women to lesbian or bisexual women. Rates of skin cancer were 8.1 percent among gay men and 8.4 percent among bisexual men, statistically higher than the rate of 6.7 percent among heterosexual men. Skin cancer rates were 5.9 percent among lesbian women and 6.6 percent among heterosexual women, which was not a statistically significant difference. However, the rate of 4.7 percent among bisexual women was statistically significantly lower than heterosexual women.

The authors note that the data are based on self-reported skin cancer diagnoses, which have not been confirmed by a physician. The SOGI module was also only implemented in 37 states, so may not be generalizable to all states.

The BRFSS survey did not collect information about risk factors for skin cancer, such as UV exposure, Fitzpatrick skin type (a measure of skin color and susceptibility to sun burn), HIV status and more. However, smaller studies have reported higher usage of indoor tanning beds among sexual minority men, a known risk factor for skin cancer.

The CDC recently considered stopping implementation of the SOGI module for future BRFSS surveys, a move Mostaghimi feels would hinder efforts to support this population.

"This is the first time we've been able to look nationally at data about skin cancer rates among sexual minorities. Eliminating SOGI would prevent us from better studying this vulnerable population over time to see how rates may change from year to year," said Mostaghimi. "As a next step, we want to connect with sexual minority communities to help identify the cause of these differences in skin cancer rates. This is work that will need to be done thoughtfully but may help not just sexual minorities but everyone."

###

Mostaghimi reported receiving personal fees from Pfizer, personal fees and equity from Hims, personal fees from 3derm, equity from Lucid, and has performed clinical trials sponsored by Eli Lilly and Company, Aclaris Therapeutics, and Concert Pharmaceuticals outside the submitted work.

Paper cited: Singer S et al. "Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States" JAMA Dermatology DOI: 10.1001/jamadermatol.2019.4196

Brigham Health, a global leader in creating a healthier world, consists of Brigham and Women's Hospital, Brigham and Women's Faulkner Hospital, the Brigham and Women's Physicians Organization and many related facilities and programs. With more than 1,000 inpatient beds, approximately 60,000 inpatient stays and 1.7 million outpatient encounters annually, Brigham Health's 1,200 physicians provide expert care in virtually every medical and surgical specialty to patients locally, regionally and around the world. An international leader in basic, clinical and translational research, Brigham Health has nearly 5,000 scientists, including physician-investigators, renowned biomedical researchers and faculty supported by over $700 million in funding. The Brigham's medical preeminence dates back to 1832, and now, with 19,000 employees, that rich history is the foundation for its commitment to research, innovation, and community. Boston-based Brigham and Women's Hospital is a teaching affiliate of Harvard Medical School and dedicated to educating and training the next generation of health care professionals. For more information, resources, and to follow us on social media, please visit brighamandwomens.org.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.