Indoor Tanning and Risk of Melanoma: A Case-Control Study in a Highly Exposed Population

Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
Cancer Epidemiology Biomarkers & Prevention (Impact Factor: 4.13). 06/2010; 19(6):1557-68. DOI: 10.1158/1055-9965.EPI-09-1249
Source: PubMed


Indoor tanning has been only weakly associated with melanoma risk; most reports were unable to adjust for sun exposure, confirm a dose-response, or examine specific tanning devices. A population-based case-control study was conducted to address these limitations.
Cases of invasive cutaneous melanoma, diagnosed in Minnesota between 2004 and 2007 at ages 25 to 59, were ascertained from a statewide cancer registry; age-matched and gender-matched controls were randomly selected from state driver's license lists. Self-administered questionnaires and telephone interviews included information on ever use of indoor tanning, types of device used, initiation age, period of use, dose, duration, and indoor tanning-related burns. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for known melanoma risk factors.
Among 1,167 cases and 1,101 controls, 62.9% of cases and 51.1% of controls had tanned indoors (adjusted OR 1.74; 95% CI, 1.42-2.14). Melanoma risk was pronounced among users of UVB-enhanced (adjusted OR, 2.86; 95% CI, 2.03-4.03) and primarily UVA-emitting devices (adjusted OR, 4.44; 95% CI, 2.45-8.02). Risk increased with use: years (P < 0.006), hours (P < 0.0001), or sessions (P = 0.0002). ORs were elevated within each initiation age category; among indoor tanners, years used was more relevant for melanoma development.
In a highly exposed population, frequent indoor tanning increased melanoma risk, regardless of age when indoor tanning began. Elevated risks were observed across devices.
This study overcomes some of the limitations of earlier reports and provides strong support for the recent declaration by the IARC that tanning devices are carcinogenic in humans.

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Available from: Deann Lazovich, Oct 02, 2015
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    • "hours (Po0.001), or sessions (P ¼ 0.001). Odds ratios were elevated within each initiation age category; years of use among indoor tanners was more relevant for melanoma development (Lazovich et al., 2010). More comprehensive analyses and reviews have recently been published that examine the relationship between indoor tanning and non-melanoma skin cancer and melanoma (Boniol et al., 2012; Wehner et al., 2012). "
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    ABSTRACT: Teenage use of indoor tanning has reached epidemic proportions. There is no Federal ban on teen use; rather, it is left to each state to determine policy. We conducted a state-by-state analysis using data from each state's statutes and regulations and supplementary information from the National Conference of State Legislatures. First, we refined an earlier 35-item instrument to now include 56 items that extensively measures age bans, parental involvement, warnings/information, enforcement, and operating requirements. To grade each tanning law, we developed a uniform scoring system with a goal of providing performance data for future comparisons. As of August 2012, 13 states had no tanning facility statute or regulation for minors. In states with some regulations, teen bans are lax -nearly uniformly, most young children under the age of 14 can legally tan with or without suboptimal parental consent or accompaniment laws. Strong Food and Drug Administration involvement alone can simplify and unify the inconsistencies that exist among states' indoor tanning laws. Until consistent regulations are promulgated and enforced, such an instrument can provide a benchmark for state investigations into the deficiencies and progress of their laws, as well as facilitate direct comparison between states for research and educational purposes.Journal of Investigative Dermatology accepted article preview online, 23 August 2013. doi:10.1038/jid.2013.357.
    Journal of Investigative Dermatology 08/2013; 134(3). DOI:10.1038/jid.2013.357 · 7.22 Impact Factor
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    • "Recent studies offer evidence to support two different mechanisms by which early onset of indoor tanning affects melanoma risk. Initiation of the behavior at a young age may increase the cumulative exposure, leading to greater likelihood of melanoma [9] [10]. For a subset of persons genetically predisposed to melanoma, earlier use of indoor tanning may accelerate melanoma development and cause it to occur at a younger age [10]. "
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    ABSTRACT: Indoor tanning usually begins during adolescence, but few strategies exist to discourage adolescent use. We developed and tested a parent-teenager intervention to decrease indoor tanning use. Through focus groups, we identified key messages to enhance parent-teenager communication about indoor tanning, and then developed a pamphlet for parents and postcards for adolescents to use in a direct mail experiment with randomly selected households. Two weeks after the mailing, we asked intervention parents (n = 87) and adolescents (n = 69) and nonintervention parents (n = 31) and adolescents (n = 28) about intervention receipt and content recall, parental concern, monitoring, parent-teenager conversations, and indoor tanning intention. In intervention households, 54% of mothers and 56% of girls recalled receipt and reported reading materials, but few boys and no fathers did. Among mothers, 57% in intervention households indicated concern about daughters' indoor tanning, and 25% would allow daughters to tan indoors, whereas 43% of nonintervention mothers had concerns and 46% would allow indoor tanning. Fewer girls in intervention households than in nonintervention households thought parents would allow indoor tanning (44% vs. 65%), and fewer intended to tan indoors (36% vs. 60%). Most mothers and daughters who read the intervention materials also reported discussions about indoor tanning. Moreover, the less likely girls were to think that their mothers would allow indoor tanning, the less likely it was that they intended to tan indoors, a relationship mediated by perceptions of maternal monitoring. A systematic qualitative and quantitative research approach yielded well-received indoor tanning prevention messages for mothers and female adolescents. Enhancing maternal monitoring has potential to decrease adolescent indoor tanning.
    Journal of Adolescent Health 05/2013; 52(5 Suppl):S76-82. DOI:10.1016/j.jadohealth.2012.08.009 · 3.61 Impact Factor
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    • "In addition, the greater risk for skin cancer has been observed for those who start tanning at younger ages [8] [9] [12]. Recent evidence suggests this observation is likely due to increased cumulative exposure over the lifespan [10]. "
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    ABSTRACT: Exposure to ultraviolet radiation and a history of sunburn in childhood contribute to risk of skin cancer in adolescence and in adulthood, but many adolescents continue to seek a tan, either from the sun or from tanning beds (i.e., intentional tanning). To understand tanning behavior among adolescents, we conducted a systematic review of the literature to identify correlates of intentional tanning in the United States. We included articles on original research published in English between January 1, 2001, and October 31, 2011, that used self-reported data on intentional tanning by U.S. adolescents aged 8 to 18 years and examined potential correlates of tanning behaviors. Thirteen articles met our criteria; all used cross-sectional survey data and quantitative methods to assess correlates of intentional tanning. Results indicate that multiple factors influence tanning among adolescents. Individual factors that correlated with intentional tanning include demographic factors (female sex, older age), attitudes (preferring tanned skin), and behaviors (participating in other risky or appearance-focused behaviors such as dieting). Social factors correlated with intentional tanning include parental influence (having a parent who tans or permits tanning) and peer influence (having friends who tan). Only four studies examined broad contextual factors such as indoor tanning laws and geographic characteristics; they found that proximity to tanning facilities and geographic characteristics (living in the Midwest or South, living in a low ultraviolet area, and attending a rural high school) are associated with intentional tanning. These findings inform future public health research and intervention efforts to reduce intentional tanning.
    Journal of Adolescent Health 05/2013; 52(5 Suppl):S52-9. DOI:10.1016/j.jadohealth.2012.09.021 · 3.61 Impact Factor
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