Indoor Tanning and Skin Cancer Among Gay, Bisexual Men and Women

Gay and bisexual men indoor tan more frequently and report higher rates of skin cancer than heterosexual men, according to an article published online by JAMA Dermatology.1
Skin cancer is the most common cancer in the United States, with approximately 5 million Americans treated annually. Data suggest sexual minority (self-reported homosexual, gay or bisexual) men may be more likely to engage in indoor tanning and to develop skin cancer. Indoor tanning is strongly associated with body image and appearance concerns. No study has assessed skin cancer prevalence or indoor tanning behaviors by sexual orientation in women, according to the study background.
Sarah Arron, M.D., Ph.D., of the University of California, San Francisco, and coauthors investigated the prevalence of a history of skin cancer and a history of indoor tanning among sexual minority men and women compared with heterosexuals. The authors used data from California Health Interview Surveys (CHISs) and the National Health Interview Survey (NHIS). The study included 78,487 heterosexual men, 3,083 sexual minority men, 107,976 heterosexual women and 3,029 sexual minority women.
Data from the state (2001-2005 CHISs) indicate skin cancer prevalence was higher among sexual minority men (4.3 percent) compared with heterosexual men (2.7 percent). National data (2013 NHIS) showed comparably higher rates of skin cancer among sexual minority men (6.7 percent) compared with heterosexual men (3.2 percent).  When it comes to indoor tanning, sexual minority men were more likely than heterosexual men to report having tanned indoors.
Sexual minority women were less likely than heterosexual women to report having had nonmelanoma skin cancer or having tanned indoors, according to the study.
“Our study highlights disparities by sexual orientation in skin cancer history and indoor tanning, a known behavioral risk factor for skin cancer. This finding may inform practice by increasing awareness among practitioners and the larger medical community and by raising the need for better public health efforts, specifically, targeting risk behaviors among sexual minority men,” the authors conclude.
In a related editorial2, Aaron J. Blashill, Ph.D., of San Diego State University, and Sherry Pagoto, Ph.D., of the University of Massachusetts Medical School, Worcester, write: “Skin cancer risk reduction in sexual minority men is an area in urgent need of research. … Further research is also needed to determine where sexual minority men engage in indoor tanning (i.e., salon vs. nonsalon locations) and to describe the nature of their tanning habits. Finally, skin cancer prevention interventions are also needed to reduce risk behavior in this population. Physicians can improve care and lend insights about this population by assessing sexual orientation as part of routine care and entering it into electronic medical records. Ultimately, reducing health disparities in sexual minorities will also require recognizing and eliminating bias and stigma in both research and clinical practice.”
1. JAMA Dermatology. Published online October 7, 2015. doi:10.1001/jamadermatol.2015.3126. 
2. JAMA Dermatology. Published online October 7, 2015. doi:10.1001/jamadermatol.2015.3125.