Disparities in Cancer-Related Risk Behaviors by Sexual Orientation in Adolescents: Youth Risk Behavior Surveillance System (YRBSS)

Objective: We examined disparities in several risk behaviors for cancer in sexual-minority (SM) adolescents relative to heterosexuals. Method: We pooled YRBS data from 14 states and 2 years (2005/2007, weighted N>34,000), examining tobacco and alcohol use, sexual-risk behaviors, and diet and exercise. Sexual orientation was defined by sexual attraction or behavior. Recommended guidelines defined risk. Analyses involved t-test for mean differences and logistic regression for odd's ratios (OR). Results: SMs began smoking or drinking alcohol at younger ages (e.g., 12.4 vs. 13.0 for smoking, p<.0001) and more SMs recently (past month) smoked cigarettes or cigars or chewed tobacco. Although more heterosexuals had ever used alcohol (OR=0.79, 95%CI=.68-.92), more SMs recently drank (OR=1.79, 95%CI=1.66-1.94) and the mean frequency of recent binge drinking (5+ drinks) was higher for SMs (>5 vs. 2.5 days in the past month, p<.0001). Sexual risk (either sex before age 16 or sex at or after age 16 and > 1 lifetime partner) was elevated among the SMs (OR=2.4, 95%CI=2.15-2.54), as was recent numbers of partners, no condom use, and using drugs during sex. While more SMs met recommended guidelines for daily servings of vegetables and fruits (OR=0.61, 95%CI=0.53-0.71), more SMs had too low or too high BMIs, purged recently, and did not meet recommended guidelines for physical activity in the past week (ORs from 1.27-4.16, p<.0001). The extent to which age, gender, or ethnicity/race modifies the cancer-related disparities will be examined. Conclusion: SM adolescents may be at risk for developing various cancers and related co-morbidities in adulthood.