Nonmelanoma Skin Cancer Prevalence by Sexual Orientation: A Repeated Cross-sectional Study of US Adults, 2022 to 2023

Abstract Background: Sexual minority individuals seem to be at higher risk for skin cancer than heterosexual individuals. This repeated cross-sectional study of US adults examined lifetime self-reported nonmelanoma skin cancer (NMSC) prevalence by sexual orientation and across race/ethnicity and gender. Methods: Using 2022 and 2023 waves of the Behavioral Risk Factor Survey System, we calculated self-reported lifetime NMSC by sexual orientation among US adults, using unadjusted and age-adjusted modified Poisson models employing complex sampling design weights. Results: Compared with heterosexual individuals, age-adjusted NMSC was higher among gay/lesbian individuals (age-adjusted prevalence ratio, 1.37; 95% confidence interval, 1.08–1.74). Prevalence did not differ among bisexual individuals and was lower among individuals who reported “something else/don’t know” (0.52, 0.44–0.60) or refused to answer (0.78, 0.68–0.88). Results varied across race/ethnicity and gender. Racial/ethnic minority (REM) gay/lesbian individuals (3.59, 1.30–9.87) had a higher prevalence compared with REM heterosexual individuals. Non-Latine White gay/lesbian individuals (1.12, 0.96–1.32) had a higher prevalence than non-Latine White heterosexual individuals, though not significant. Gay men (1.12, 0.92–1.37) reported elevated, though not significant, prevalence compared with heterosexual men, whereas lesbian women (1.52, 1.04–2.23) had a higher prevalence compared with heterosexual women. Conclusions: We found heterogeneity in NMSC prevalence by sexual orientation across racial/ethnic and gender groups. Gay/lesbian individuals reported higher prevalence than their heterosexual counterparts across strata, but disparities were most pronounced among REM gay/lesbian individuals. Impact: There is a critical need to understand the factors driving differential burden and address modifiable NMSC risk factors to reduce disparities.