Importance:Sexual minority men have reported higher rates of both indoor tanning and skin cancer than heterosexual men, and sexual minority women have reported lower or equal rates of both indoor tanning and skin cancer 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. Objective:To evaluate the association between sexual orientation and lifetime prevalence of skin cancer. Design, Setting, and Participants:This cross-sectional study analyzed data from the 2014-2018 Behavioral Risk Factor Surveillance System (BRFSS) surveys of a noninstitutionalized population in the United States that included 877 650 adult participants who self-identified as being heterosexual, gay, lesbian, or bisexual. Main Outcomes and Measures:Self-reported lifetime history of skin cancer. Results:The study included 877 650 participants, including 364 833 heterosexual men (mean age, 47.7; 95% CI, 47.5-47.8), 7823 gay men (mean age, 42.7; 95% CI, 41.8-43.6), 5277 bisexual men (mean age, 39.4; 95% CI, 38.4-40.5), 484 341 heterosexual women (mean age, 49.7; 95% CI, 49.6-49.8), 5609 lesbian women (mean age, 41.8; 95% CI, 40.6-43.0), and 9767 bisexual women (mean age, 32.8; 95% CI, 32.3-33.3). The adjusted odds ratios (AORs) of skin cancer prevalence were significantly higher among both gay (AOR, 1.25; 95% CI, 1.03-1.50; P = .02) and bisexual men (AOR, 1.46; 95% CI, 1.01-2.10; P = .04) compared with heterosexual men. The AORs of skin cancer were statistically significantly lower among bisexual women (AOR, 0.75; 95% CI, 0.60-0.95; P = .02) but not among gay or lesbian women (AOR, 1.01; 95% CI, 0.77-1.33; P = .95) compared with the AORs of skin cancer among heterosexual women. Conclusions and Relevance:In this study, gay and bisexual men had an increased self-reported lifetime prevalence of skin cancer compared with the prevalence among heterosexual men. Patient education and community outreach initiatives focused on reducing skin cancer risk behaviors among gay and bisexual men may help reduce the lifetime development of skin cancer in this population. 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.

译文

重要性:与异性恋男人相比,性少数男人报告的室内日晒和皮肤癌发病率均高于异性恋男人,而性少数族裔女性则报告的室内日光浴和皮肤癌发病率低于异性恋女人。尤其是,双性恋者报告的室内日光浴床使用率高于异性恋者。但是,尚无研究对同性恋,女同性恋和双性恋者作为独立人群的皮肤癌患病率进行调查。
目的:评估性取向与皮肤癌终生患病率之间的关系。
设计,设置和参与者:这项横断面研究分析了2014-2018年行为风险因素监测系统(BRFSS)对美国非机构化人群进行的调查数据,其中包括877650名自称是异性恋的成年参与者,同性恋,女同性恋或双性恋。
主要结果和措施:自我报告的皮肤癌一生史。
结果:该研究包括877650名参与者,其中包括364833名异性恋男性(平均年龄47.7; 95%CI,47.5-47.8),7823名同性恋男性(平均年龄42.7; 95%CI,41.8-43.6),5277名双性恋男性(平均年龄,39.4; 95%CI,38.4-40.5),484341异性恋女性(平均年龄,49.7; 95%CI,49.6-49.8),5609女同性恋女性(平均年龄,41.8; 95%CI,40.6-43.0) )和9767名双性恋女性(平均年龄32.8; 95%CI 32.3-33.3)。男同性恋者(AOR,1.25; 95%CI,1.03-1.50; P = .02)和双性恋男性(AOR,1.46; 95%CI,1.01-2.10)中皮肤癌患病率的调整后优势比(AOR)均显着更高; P = .04)。在双性恋女性中,皮肤癌的AOR值在统计学上显着降低(AOR,0.75; 95%CI,0.60-0.95; P = 0.02),但在男女同性恋者中则没有(AOR,1.01; 95%CI,0.77-1.33; P = .95)与异性恋女性皮肤癌的AOR相比。
结论与相关性:在这项研究中,男同性恋者和双性恋者的终生患病率比异性恋者的患病率高。旨在减少男同性恋和双性恋者中皮肤癌危险行为的患者教育和社区外联举措可能有助于减少该人群中皮肤癌的终生发展。继续实施行为危险因素监测系统的性取向和性别认同模块对于增进对少数民族人口的健康和福祉的了解是必不可少的。

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