Investigating Skin Cancer Risk and Sun Safety Practices Among LGBTQ+ Communities in Canada

Abstract

Background: Skin cancer prevention relies on effective sun safety practices. Previous studies have shown that LGBTQ+ individuals exhibit lower sunscreen use and higher tanning bed usage compared to their non-LGBTQ+ counterparts. This study is the first to assess skin cancer risk factors, sun-protective behaviors, and skin cancer concerns among LGBTQ+ individuals across Canada.

Methods: A national survey study was conducted between July 2020 and March 2024 and included LGBTQ+ respondents aged ≥ 16 years who had completed the survey. Responses were summarized using frequency counts/percentages for categorical variables and means/standard deviations for continuous variables. Logistic regression models were used to calculate age- and gender-adjusted odds ratios for subgroup analyses.

Results: Of the 700 LGBTQ+ participants included (59.3% women; median age 38 years), the majority had a Fitzpatrick skin phototype (FSP) I-III (76.4%). Concerningly, 60% reported >10 lifetime sunburns, 58% reported ≥1 blistering sunburn, 34% had used a tanning bed ≥1 time in their lifetime, and 69% reported having a tan in the last 12 months. Sunscreen was worn regularly by only half of the respondents, and half of the participants agreed or strongly agreed with "I look better and/or healthier with a tan". Additional comparisons are presented based on gender, FSP, education, and income.

Conclusion: The findings of this study highlight the need for public health campaigns tailored to the LGBTQ+ community, emphasizing culturally sensitive sun safety education, particularly for LGBTQ+ men, individuals with FSP IV-VI, and those with lower education levels, to help reduce future skin cancer risk.

Keywords: Canadian health behavior; LGBTQ+ health; skin cancer risk; sun protection; sun safety.

Figure 1

Comparison of sun exposure, CM risk factors, sun protection habits, and level of worry for CM between women (n = 415), men (n = 248), and gender-diverse individuals (n = 37). (A) Bar graph depicting the statistically significant variables. (B) Forest plot with all the variables comparing women to men. (C) Forest plot with all the variables comparing gender diverse individuals to men. Odds ratios (OR) are adjusted for age and gender where appropriate.

Figure 2

Comparison of sun exposure, CM risk factors, sun protection habits, and level of worry for CM between Fitzpatrick skin phototypes I–III (n = 535) vs. phototypes IV–VI (n = 164) as a bar graph with the statistically significant variables (A) and corresponding forest plot with all variables (B). Odds ratios (OR) are adjusted for age and gender where appropriate.

Figure 3

Comparison of sun exposure, CM risk factors, sun protection habits, and level of worry for CM between those who have completed a university degree (n = 409) vs. those who have not completed a university degree (n = 249), depicted as a bar graph with the statistically significant variables (A) and corresponding forest plot with all variables (B). Odds ratios (OR) are adjusted for age and gender where appropriate.

Figure 4

Comparison of sun exposure, CM risk factors, sun protection habits, and level of worry for CM between individuals with an annual household income ≥ CAD 50,000 (n = 459) vs. individuals with an annual income < CAD 50,000 (n = 152) as a bar graph with the statistically significant variables (A) and corresponding forest plot with all variables (B). Odds ratios (OR) are adjusted for age and gender where appropriate.