1
|
Nurla LA, Wafi G, Tatar R, Dorobanțu AM, Chivu M, Popa LG, Giurcăneanu C, Orzan OA. Recent-Onset Melanoma and the Implications of the Excessive Use of Tanning Devices-Case Report and Review of the Literature. Medicina (Kaunas) 2024; 60:187. [PMID: 38276066 PMCID: PMC10821341 DOI: 10.3390/medicina60010187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/19/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
Introduction: Melanoma, a malignant tumor arising from uncontrolled melanocytic proliferation, commonly found in the skin but capable of affecting extracutaneous sites, ranks fifth among diagnosed oncological entities and is a significant cause of cancer deaths, constituting over 80% of skin cancer mortality. Genetic factors and ultraviolet radiation (UVR) exposure, from both natural and artificial sources, are the primary risk factors. Case Presentation: We reported the case of a 25-year-old female with numerous pigmented nevi and notable changes attributed to extensive indoor tanning sessions. Dermatological examinations and dermoscopic evaluations revealed atypical features in two pigmented nevi, leading to surgical excision. Histopathological and immunohistochemical analyses confirmed a compound nevus in one lesion and superficial spreading melanoma in the other, emphasizing the importance of vigilant follow-up and the correct use of immunohistochemistry. Discussion: Indoor tanning significantly elevates the cutaneous melanoma risk, with initiation before age 35 amplifying the risk by up to 75%, especially in young women. The risk escalates with cumulative sessions, particularly exceeding 480, and individuals undergoing over 30 sessions face a 32% higher risk. UVR induces DNA damage, genetic mutations, and immunosuppression, contributing to oncogenesis. Genetic factors, like the PTCHD2 gene, may influence the tanning dependency. Legislation targeting minors has been enacted globally but only with partial efficacy. Tanning accelerators, though associated with minor side effects, correlate with high-risk behaviors. The case underscores the urgency of addressing indoor tanning risks, emphasizing targeted awareness efforts and legislative improvements. Conclusions: In conclusion, the reported case highlights the increased risk of cutaneous melanoma linked to indoor tanning, particularly among young women and specific sociodemographic groups. Despite legislative measures, challenges persist, suggesting the potential efficacy of online campaigns involving relatable influencers to raise awareness and discourage artificial tanning.
Collapse
Affiliation(s)
- Luana-Andreea Nurla
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
- Institute of Doctoral Studies, Doctoral School of Medicine, “Ovidius” University of Constanta, 900573 Constanta, Romania
| | - Gina Wafi
- Dermatovenerology Clinic, “Victor Babeș” Clinical Hospital for Infectious and Tropical Diseases, 030303 Bucharest, Romania
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alexandra Maria Dorobanțu
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Mădălina Chivu
- Department of Pathology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Liliana Gabriela Popa
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Călin Giurcăneanu
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Olguța Anca Orzan
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| |
Collapse
|
2
|
Roth A, Boutko A, Lampley N, Olivares S, Gerami P. Indoor tanning is associated with an increased risk of multiple primary melanomas: A case-control study. J Am Acad Dermatol 2023; 88:867-868. [PMID: 36400324 DOI: 10.1016/j.jaad.2022.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/09/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Andrew Roth
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anastasiya Boutko
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Nathaniel Lampley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Robert H. Lurie Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| |
Collapse
|
3
|
Erickson KL, Fan C, Eley SJ, Vaccarello A, Xu JR, Gendi SW, Bordeaux JS. UV safety recommendations and health claims by U.S. tanning salon operators in a nationally representative sample. J Cosmet Dermatol 2023; 22:674-676. [PMID: 36045511 PMCID: PMC10087760 DOI: 10.1111/jocd.15288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Kayley L Erickson
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Cong Fan
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sarah J Eley
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Annalise Vaccarello
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - James R Xu
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Steve W Gendi
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
4
|
Yousef S, Papadimitropoulos M, Faris M, Hasan H, Hossain A, Colman I, Manuel D, Wells GA. Melanin levels in relation to vitamin D among first-generation immigrants from different ethnic groups and origins: A comparative national Canadian cross-sectional study. Front Med (Lausanne) 2023; 9:992554. [PMID: 36698822 PMCID: PMC9868151 DOI: 10.3389/fmed.2022.992554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Immigrants to Western countries tend to have darker skin than native-born populations. We examined the relationship between skin melanin and serum vitamin D (vitD) [S-25(OH)D] levels and explored whether melanin levels explained S-25(OH)D variations between immigrants and native-born Canadians. This study offers novel findings as no such study has been conducted. Methods We used a national cross-sectional population-based design with data from the Canadian Health Measures Survey (CHMS). Skin melanin levels among first-generation immigrants based on their ethnicity and origin/country of birth were compared with white and native-born populations. We assessed the association between S-25(OH)D and melanin after adjusting for independent variables related to S-25(OH)D, melanin level, and immigration status. Results Of 11,579 participants, 21.9% were immigrants aged 3-79 years (mean age 39.23 years). Compared with non-immigrants, immigrants had lower S-25(OH)D levels (mean: 51.23 vs. 62.72; 95% CI: 8.37, 14.62; P < 0.001) but higher melanin levels (mean [SE]: 17.08 [0.25] vs. 16.29 [0.29]; 95% CI: -1.29, -0.281; P = 0.004). Melanin did not differ by length of stay in Canada but was weakly positively correlated (r = 0.088, P < 0.001) with S-25(OH)D. Sex (male), age (≥18 years), summer/fall seasons, sunlight exposure, sunscreen non-use, smoking, and alcohol consumption were associated with higher melanin levels, whereas indoor tanning use was not. Conclusion Skin melanin levels were associated with sociodemographic and behavioral characteristics. Immigrants had higher melanin levels, but melanin did not differ by length of stay in Canada. The weak positive correlation between melanin and S-25(OH)D suggested confounding factors may impact the relationship between melanin levels, S-25(OH)D, and immigration status.
Collapse
Affiliation(s)
- Said Yousef
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada,Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON, Canada,*Correspondence: Said Yousef,
| | - Manny Papadimitropoulos
- Eli Lilly Canada Inc., Toronto, ON, Canada,Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - MoezAlIslam Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alomgir Hossain
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Douglas Manuel
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada,Ottawa Hospital Research Institute, Ottawa, ON, Canada,Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - George A. Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada,Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON, Canada
| |
Collapse
|
5
|
Dessinioti C, Stratigos AJ. An Epidemiological Update on Indoor Tanning and the Risk of Skin Cancers. Curr Oncol 2022; 29:8886-903. [PMID: 36421352 DOI: 10.3390/curroncol29110699] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Indoor tanning (sunbeds, solarium) uses artificial ultraviolet radiation (UVR) to stimulate cosmetic tanning of the skin. Indoor tanning has been officially classified as a human carcinogen in 2009 by the International Agency for Research on Cancer of the World Health Organization (WHO). The differences in the prevalence of sunbed use across countries and over the years highlight underlying legislative, climatic, and cultural differences. Indoor tanning-seeking behaviors may be driven by motivations for an appealing appearance, largely influenced by gender and age, and several misconceptions that a prevacation tan safeguards the skin, that sunbeds can be used to treat acne or to increase vitamin D, or that tanning is a healthy habit. This review provides an epidemiological update on the prevalence of sunbed use, who tends to use sunbeds and why, and details the current evidence on the association of sunbeds with skin cancers, including cutaneous melanoma, basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC). A statistically significant higher risk of cutaneous melanoma, BCC and cSCC with the use of sunbeds has been consistently demonstrated. This risk of skin cancer is even higher with the more frequent use of sunbeds, underscoring a dose-response relationship, and in those first exposed to sunbeds at a younger age. Preventive measures against sunbed use include legislation restricting sunbed use, educational campaigns to inform and discourage from indoor tanning, as well as using the internet, online advertising messages and the social media to reach larger audiences and to promote an untanned appearance.
Collapse
|
6
|
Buller DB, Pagoto S, Henry KL, Baker K, Walkosz BJ, Hillhouse J, Berteletti J, Bibeau J. Effects of Engagement with a Social Media Campaign for Mothers to Prevent Indoor Tanning by Teens in a Randomized Trial. J Health Commun 2022; 27:394-406. [PMID: 35993376 PMCID: PMC9643633 DOI: 10.1080/10810730.2022.2113839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In a social media campaign aimed at reducing mothers' permissiveness for indoor tanning (IT) by their teenage daughters, a secondary analysis of campaign engagement effects on IT outcomes was performed. Mothers (n = 869) with daughters aged 14-17 were recruited in 34 states that did not ban IT by minors under age 18 for a randomized trial with follow-up at 12 months (end of intervention) and 18 months (6 months after intervention) post-randomization. Daughters' (n = 469) baseline and follow-up responses were analyzed too. Mothers received a Facebook feed on adolescent health topics that included posts about preventing IT (intervention) or prescription drug misuse (control). Engagement was measured by extracting reactions (e.g., like, sad, etc.) and comments posted by mothers to the campaign posts. Overall, 76.4% of posts received a reaction and/or comment. Mothers who engaged with IT posts were less permissive of daughters' IT immediately at the conclusion of the campaign (permit IT: -0.39, p < .05; facilitate IT: -0.29, p < .05) and 6 months after intervention (permit IT: -0.32, p < .05; facilitate IT: -0.31, p < .05) than mothers who did not engage with posts. Engagement with posts was essential to the success of a social media campaign for preventing IT by minors by reducing mothers' permissiveness.
Collapse
Affiliation(s)
| | - Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Ft. Collins, Colorado, USA
| | - Katie Baker
- Department of Community and Behavioral Health, College of Public Health, Sherrod Library 353, East Tennessee State University, Johnson City, Tennessee, USA
| | | | - Joel Hillhouse
- Department of Community and Behavioral Health, College of Public Health, Lamb Hall, Suite 300, East Tennessee State University, Johnson City, Tennessee, USA
| | | | - Jessica Bibeau
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| |
Collapse
|
7
|
An S, Kim K, Moon S, Ko KP, Kim I, Lee JE, Park SK. Indoor Tanning and the Risk of Overall and Early-Onset Melanoma and Non-Melanoma Skin Cancer: Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:5940. [PMID: 34885049 DOI: 10.3390/cancers13235940] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Motivated by the increasing incidences of skin cancer, in 2015, Australian states banned indoor tanning to prevent exposure to artificial ultraviolet light. However, there has been no study investigating the association between indoor tanning and early-onset melanoma and non-melanoma skin cancer. In this study, we reviewed a total of 54 studies to examine the association between indoor tanning device use and overall and early-onset skin cancer. We found that indoor tanning is associated with increased risk for early-onset melanoma and NMSC, and has a dose–response relationship with first exposure at an early age and the frequency of exposure. Therefore, this study emphasizes the importance of avoiding indoor tanning risk in younger adults. Our findings provide evidence that supports policies regulating the excessive use of tanning devices, especially in the vulnerable younger population, to reduce the additional risk of skin cancer. Abstract The aim of this study was to examine the association between indoor tanning use and the risk of overall and early-onset (age < 50) melanoma and non-melanoma skin cancer (NMSC). To evaluate the association between indoor tanning and skin cancer, a systematic review of the literature published until July 2021 was performed using PubMed, EMBASE, and MEDLINE. Summary relative risk (RR) from 18 studies with 10,406 NMSC cases and 36 studies with 14,583 melanoma cases showed significant association between skin cancer and indoor tanning (melanoma, RR= 1.27, 95% CI 1.16–1.39; NMSC, RR = 1.40, 95% CI 1.18–1.65; squamous cell carcinoma (SCC), RR = 1.58, 95% CI 1.38–1.81; basal cell carcinoma (BCC), RR = 1.24, 95% CI 1.00–1.55). The risk was more pronounced in early-onset skin cancer (melanoma, RR = 1.75, 95% CI 1.14–2.69; NMSC, RR = 1.99, 95% CI 1.48–2.68; SCC, RR = 1.81, 95% CI 1.38–2.37; BCC, RR = 1.75, 95% CI 1.15–2.77). Moreover, first exposure at an early age (age ≤ 20 years) and higher exposure (annual frequency ≥ 10 times) to indoor tanning showed increasing risk for melanoma (RR = 1.47, 95% CI 1.16–1.85; RR = 1.52, 1.22–1.89) and NMSC (RR = 2.02, 95% CI 1.44–2.83; RR = 1.56, 95% CI 1.31–1.86). These findings provide evidence supporting primary prevention policies regulating modifiable behaviors to reduce the additional risk of skin cancer among younger adults.
Collapse
|
8
|
LeWitt TM, Farshchian M, Grant-Kels JM, Daveluy S. Ethics of skin cancer treatment in a patient who continues with indoor tanning. J Am Acad Dermatol 2021; 86:1452-1453. [PMID: 34752822 DOI: 10.1016/j.jaad.2021.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/27/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Tessa M LeWitt
- School of Medicine, Wayne State University, Detroit, Michigan
| | - Mehdi Farshchian
- Department of Dermatology, Wayne State University, Detroit, Michigan
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Dermatology, University of Florida, Gainesville, Florida.
| | - Steven Daveluy
- Department of Dermatology, Wayne State University, Detroit, Michigan
| |
Collapse
|
9
|
Diehl K, Breitbart EW, de Buhr Y, Schneider S, Görig T. Shift in place of tanning bed use from tanning salons to spa, fitness, and beauty facilities: A trend perspective. Photodermatol Photoimmunol Photomed 2021; 38:83-85. [PMID: 34157183 DOI: 10.1111/phpp.12711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/05/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Yvonne de Buhr
- Arbeitsgemeinschaft Dermatologische Prävention (ADP) e.V, Hamburg, Germany
| | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tatiana Görig
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
10
|
Gordon LG, Hainsworth R, Eden M, Epton T, Lorigan P, Grant M, Green AC, Payne K. Sunbed Use among 11- to 17-Year-Olds and Estimated Number of Commercial Sunbeds in England with Implications for a 'Buy-Back' Scheme. Children (Basel) 2021; 8:393. [PMID: 34068910 DOI: 10.3390/children8050393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022]
Abstract
Prior to 2011 legislation prohibiting children from using commercial sunbeds, the prevalence of sunbed use in 15- to 17-year-olds in some areas in England was as high as 50%. Despite significant decreases since 2011, children today still practice indoor tanning. We estimated current sunbed use in 11- to 17-year-olds in England, the number of available commercial sunbed units, and the associated cost of a ‘buy-back’ scheme to remove commercial sunbeds under a potential future policy to ban sunbeds. We undertook a calibration approach based on published prevalence rates in English adults and other sources. Internet searches were undertaken to estimate the number of sunbed providers in Greater Manchester, then we extrapolated this to England. Estimated mean prevalence of sunbed use was 0.6% for 11- to 14-year-olds and 2.5% for 15- to 17-year-olds, equating to 62,130 children using sunbeds in England. A predicted 2958 premises and 17,865 sunbeds exist nationally and a ‘buy-back’ scheme would cost approximately GBP 21.7 million. Public health concerns remain greatest for 11- to 17-year-olds who are particularly vulnerable to developing skin cancers after high ultraviolet exposure.
Collapse
|
11
|
Heckman C, Lin Y, Riley M, Wang Y, Bhurosy T, Mitarotondo A, Xu B, Stapleton J. Association Between State Indoor Tanning Legislation and Google Search Trends Data in the United States From 2006 to 2019: Time-Series Analysis. JMIR Dermatol 2021; 4:e26707. [PMID: 37632845 PMCID: PMC10501525 DOI: 10.2196/26707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Exposure to ultraviolet radiation from the sun or indoor tanning is the cause of most skin cancers. Although indoor tanning has decreased in recent years, it remains most common among adolescents and young adults, whose skin is particularly vulnerable to long-term damage. US states have adopted several types of legislation to attempt to minimize indoor tanning among minors: a ban on indoor tanning among all minors, a partial minor ban by age (eg, <14 years), or the requirement of parental consent or accompaniment for tanning. Currently, only 6 US states have no indoor tanning legislation for minors. OBJECTIVE This study investigated whether internet searches (as an indicator of interest) related to indoor tanning varied across US states by the type of indoor tanning legislation, using data from Google Trends from 2006 to 2019. METHODS We conducted a time-series analysis of Google Trends data on indoor tanning from 2006 to 2019 by US state. Time-series linear regression models were generated to assess the Google Trends data over time by the type of indoor tanning legislation. RESULTS We found that indoor tanning search rates decreased significantly for all 50 states and the District of Columbia over time (P<.01). The searches peaked in 2012 when indoor tanning received marked attention (eg, indoor tanning was banned for all minors by the first state-California). The reduction in search rates was more marked for states with a complete ban among minors compared to those with less restrictive types of legislation. CONCLUSIONS Our findings are consistent with those of other studies on the association between indoor tanning regulations and attitudinal and behavioral trends related to indoor tanning. The main limitation of the study is that raw search data were not available for more precise analysis. With changes in interest and norms, indoor tanning and skin cancer risk among young people may change. Future studies should continue to determine the impact of such public health policies in order to inform policy efforts and minimize risks to public health.
Collapse
Affiliation(s)
- Carolyn Heckman
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Yong Lin
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | | | - Yaqun Wang
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Trishnee Bhurosy
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Anna Mitarotondo
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Baichen Xu
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | | |
Collapse
|
12
|
Wei EX, Nan H, Okereke OI, Li X. Indoor tanning early in life is associated with increased risk of anxiety and depression later in life. J Am Acad Dermatol 2021:S0190-9622(21)00579-X. [PMID: 34023334 DOI: 10.1016/j.jaad.2021.02.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/28/2021] [Accepted: 02/23/2021] [Indexed: 11/20/2022]
|
13
|
Karapetyan L, Yang X, Wang H, Sander CA, Moyer A, Wilson M, Karunamurthy A, Kirkwood JM. Indoor tanning exposure in association with multiple primary melanoma. Cancer 2021; 127:560-568. [PMID: 33170961 DOI: 10.1002/cncr.33307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/17/2020] [Accepted: 10/04/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with primary cutaneous melanoma are at increased risk for subsequent new primary melanomas. Indoor tanning is a recognized risk factor for melanoma. This study was aimed at determining the association between indoor tanning and the occurrence of multiple primary melanoma. METHODS This was a retrospective case-control study of cases with multiple primary melanoma and sex-matched controls with single primary melanoma retrieved at a 1:2 ratio from the Biological Sample and Nevus Bank of the Melanoma Center of the University of Pittsburgh Cancer Institute. Logistic regression models were used to examine the association between multiple primary melanoma and risk factors. RESULTS In total, 330 patients (39.1% men) with a median age of 51 years were enrolled. Compared with patients who had a single primary melanoma, patients with multiple melanomas were younger at the diagnosis of their first primary melanoma and were more likely to be discovered at stage 0 or I and to have had indoor tanning exposure, a family history of melanoma, atypical moles, dysplastic nevi, and a Breslow thickness less than 1 mm. Compared with patients' first melanomas, subsequent melanomas were more likely to be thinner or in situ. The estimated probability of the locus for the second primary being the same as that for the first primary melanoma was 34%. In a multivariate analysis after adjustments for age, a family history of melanoma, the presence of atypical and dysplastic nevi, and recreational sun exposure, indoor tanning remained significantly associated with the occurrence of multiple primary melanoma (odds ratio, 2.75; 95% confidence interval, 1.07-7.08; P = .0356). CONCLUSIONS Indoor tanning is associated with an increased risk of second primary melanoma. Subsequent melanomas are more likely to be thin or in situ and to occur in different anatomic locations.
Collapse
Affiliation(s)
- Lilit Karapetyan
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Xi Yang
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Hong Wang
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cindy A Sander
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ashley Moyer
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Melissa Wilson
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - John M Kirkwood
- Department of Medicine, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
14
|
Singer S, Tkachenko E, Yeung H, Mostaghimi A. Skin cancer and skin cancer risk behaviors among sexual and gender minority populations: A systematic review. J Am Acad Dermatol 2020; 83:511-522. [PMID: 32068044 PMCID: PMC7369213 DOI: 10.1016/j.jaad.2020.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/01/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individuals of sexual and gender minorities may have different lifetime risk of skin cancer and ultraviolet radiation exposure than heterosexual persons. OBJECTIVE To systematically review the prevalence of skin cancer and behaviors that increase risk of skin cancer among sexual and gender minority populations. METHODS We performed a systematic literature review in PubMed/MEDLINE, Embase, Cochrane, and Web of Science, searching for articles through October 18, 2019, that investigated risk of skin cancer and behaviors among sexual and gender minority populations. RESULTS Sexual minority men have a higher lifetime risk of any skin cancer (odds ratio range: 1.3-2.1) and indoor tanning bed use (odds ratio range: 2.8-5.9) compared with heterosexual men, whereas sexual minority women may use indoor tanning beds less frequently than heterosexual women and do not have an elevated risk of lifetime history of skin cancer. Gender-nonconforming individuals have higher lifetime prevalence of any skin cancer compared with cisgender men. LIMITATIONS Most variables rely on self-reporting in their original studies. CONCLUSIONS Sexual minority men disproportionately engage in use of indoor tanning beds, which may result in increased lifetime risk of skin cancer. Recognition of this risk is important for providing appropriate screening for patients in this population.
Collapse
Affiliation(s)
- Sean Singer
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Elizabeth Tkachenko
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; University of Massachusetts Medical School, Worcester, Massachusetts
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
| |
Collapse
|
15
|
Huang CM, Kirchhof MG. Evaluation of Indoor Tanning Facilities in American Fitness Centers. J Cutan Med Surg 2020; 24:372-379. [PMID: 32441110 DOI: 10.1177/1203475420923645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Indoor tanning (IT) in fitness facilities encourages a misleading positive relationship between tanning and health. While IT in Canadian fitness facilities has been studied, American literature regarding this topic is lacking. OBJECTIVES The objective of this study is to evaluate availability, cost, reported risks, and adherence to legislation of IT in American fitness clubs. METHODS This was a cross-sectional study utilizing a telephone questionnaire to survey gyms across all 50 states. The key term "fitness club" was searched in the Yellow Pages and 20 facilities from each state were randomly included into the study. Data were described descriptively and Pearson χ2 tests were used to compare IT prevalence and rates of noncompliance between population groups. Regression analysis examined potential relationship between cost and prevalence of IT. RESULTS Of the 1000 fitness clubs surveyed, 44.4% (444/1000) offered IT. The overall noncompliance rates for age, rest time, and eye protection were 13.8% (54/390), 26.0% (20/77), and 27.8% (85/225), respectively. The most common risk reported was skin cancer (61.6%), but many facilities were unsure of risks (27.0%) and some described no risk associated with IT (3.2%). The average cost for monthly unlimited tanning was 33 ± 13.96 USD. A state-to-state comparison showed a statistically significant inverse relationship between mean cost and prevalence of IT (P = .013, [r]= -0.35). CONCLUSION The prevalence and noncompliance rates of IT in fitness clubs contradict the healthy lifestyles they are working to promote. To limit harms, legislations should be standardized and more strictly enforced. Additionally, public education on IT risks and the use of higher costs may help minimize IT use.
Collapse
Affiliation(s)
- Christina M Huang
- 12365 Division of Dermatology, Department of Medicine, University of Ottawa, ON, Canada.,The Ottawa Hospital, ON, Canada
| | - Mark G Kirchhof
- 12365 Division of Dermatology, Department of Medicine, University of Ottawa, ON, Canada.,The Ottawa Hospital, ON, Canada
| |
Collapse
|
16
|
Robsahm TE, Stenehjem JS, Berge LAM, Veierød MB. Prevalence of Indoor Tanning Among Teenagers in Norway Before and After Enforcement of Ban for Ages Under 18 Years. Acta Derm Venereol 2020; 100:adv00127. [PMID: 32285136 PMCID: PMC9128903 DOI: 10.2340/00015555-3482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Institute of Population Based Cancer Research, PB 5313 Majorstuen, NO-0304 Oslo, Norway. E-mail:
| | | | | | | |
Collapse
|
17
|
Diehl K, Görig T, Greinert R, Breitbart EW, Schneider S. Trends in Tanning Bed Use, Motivation, and Risk Awareness in Germany: Findings from Four Waves of the National Cancer Aid Monitoring (NCAM). Int J Environ Res Public Health 2019; 16:E3913. [PMID: 31618885 DOI: 10.3390/ijerph16203913] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/08/2019] [Accepted: 10/11/2019] [Indexed: 12/15/2022]
Abstract
Indoor tanning is an important risk factor for the development of melanoma and non-melanoma skin cancer. With our nationally representative monitoring, we aimed at describing tanning bed use, user characteristics, reasons for use, and risk awareness over time. In the framework of the National Cancer Aid Monitoring (NCAM), we collected representative data on 12,000 individuals aged 14 to 45 years in annual waves of n = 3,000 participants in Germany between 2015 and 2018. We used descriptive statistics and chi²-tests to uncover group differences. To compare data from the different waves, we calculated confidence intervals. The use of tanning beds decreased from 2015 (11.0%, 95%-CI: 9.9%–12.1%) to 2018 (8.8%, 95%-CI: 7.8%–9.8%). However, this decrease did not affect all subgroups. For instance, there was an (non-significant) increase in minors and the prevalence remained stable for individuals with immigrant background and males. Attractiveness was an important reason for tanning bed use in each wave. Over time, there was an increase in medical-related reasons for use. Furthermore, monitoring showed a decrease in risk awareness regarding tanning bed use and ultraviolet (UV) radiation. While it is a positive development that the overall use of tanning beds in Germany has decreased over time, the increasing use by minors despite the legal ban is alarming. Due to the declining risk awareness it is necessary to implement prevention and education campaigns specifically targeted at this group.
Collapse
|
18
|
Gosselin S, McWhirter JE. Assessing the content and comprehensiveness of provincial and territorial indoor tanning legislation in Canada. Health Promot Chronic Dis Prev Can 2019; 39:45-55. [PMID: 30767854 DOI: 10.24095/hpcdp.39.2.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Canadian provincial and territorial governments have enacted legislation in response to health risks of artificial ultraviolet radiation from indoor tanning. This legislation, which differs from jurisdiction to jurisdiction, regulates the operation of indoor tanning facilities. The content and comprehensiveness of such legislation-and its differences across jurisdictions-have not been analyzed. To address this research gap, we conducted a systematic, comprehensive scan and content analysis on provincial and territorial indoor tanning legislation, including regulations and supplementary information. METHODS Legislative information was collected from the Canadian Legal Information Institute database and an environmental scan was conducted to locate supplementary information. Through a process informed by the content of the legislation, previous research and health authority recommendations, we developed a 59-variable codebook. Descriptive statistics were calculated. RESULTS All provinces and one of three territories have legislation regulating indoor tanning. Areas of strength across jurisdictions are youth access restrictions (n = 11), posting of warning signs (n = 11), penalties (n = 11) and restrictions on advertising and marketing targeted to youth (n = 7). Few jurisdictions, however, cover areas such as protective eyewear (n = 4), unsupervised tanning (n = 4), provisions for inspection frequency (n = 4), misleading health claims in advertisements directed toward the general public (n = 2) and screening of high-risk clients (n = 0). CONCLUSION All provinces and one territory have made progress in regulating the indoor tanning industry, particularly by prohibiting youth and using warning labels to communicate risk. Legislative gaps should be addressed in order to better protect Canadians from this avoidable skin cancer risk.
Collapse
Affiliation(s)
- Sydney Gosselin
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Jennifer E McWhirter
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
19
|
Carcioppolo N, Peng W, Lun D, Occa A. Can a Social Norms Appeal Reduce Indoor Tanning? Preliminary Findings From a Tailored Messaging Intervention. Health Educ Behav 2019; 46:818-823. [PMID: 30938186 DOI: 10.1177/1090198119839105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Perceived social norms are routinely observed as positive predictors of indoor tanning. Past research has suggested that messaging interventions target normative perceptions to reduce indoor tanning behavior. Despite this call, little empirical research has investigated the utility of taking a social norms approach in behavioral interventions. The present study addresses this gap by conducting a quasi-experiment (N = 206) assessing the effect of an intervention message correcting normative misperceptions on indoor tanning intentions at different levels of tanning frequency. Results suggest that tailored normative intervention messages can successfully reduce tanning intentions among high-frequency tanners, those who scored at the 75th and 90th percentile of tanning frequency (f2 for interaction = .015). These results provide preliminary empirical evidence to support previous theorizing on the efficacy of social norms interventions among high-frequency indoor tanners.
Collapse
Affiliation(s)
| | - Wei Peng
- University of Miami, Coral Gables, FL, USA
| | - Di Lun
- University of Miami, Coral Gables, FL, USA
| | | |
Collapse
|
20
|
Yeung H, Luk KM, Chen SC, Ginsberg BA, Katz KA. Dermatologic care for lesbian, gay, bisexual, and transgender persons: Epidemiology, screening, and disease prevention. J Am Acad Dermatol 2019; 80:591-602. [PMID: 30744875 PMCID: PMC6375301 DOI: 10.1016/j.jaad.2018.02.045] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) persons face important health issues relevant to dermatologists. Men who have sex with men (MSM) are at higher risk of certain infectious diseases, including HIV, syphilis and other sexually transmitted diseases (STDs), methicillin-resistant Staphylococcus aureus infections, and invasive meningococcal disease, and might be at higher risk of non-infectious conditions, including skin cancer. Recommendations for preventive health care, including screening for HIV and other STDs, sexual health-related vaccinations, and HIV pre-exposure prophylaxis, differ for MSM compared with non-MSM. Women who have sex with women experience disparities in STDs, including chlamydia and HPV. Transgender patients have unique, and often unmet, dermatologic needs during gender transition (also called gender affirmation), related to hormonal therapy and gender-affirming surgery. Familiarity with LGBT health issues and disease-prevention guidelines can enable dermatologists to provide medically appropriate and culturally competent care to LGBT persons.
Collapse
Affiliation(s)
- Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
| | - Kevin M Luk
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Suephy C Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Division of Dermatology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Brian A Ginsberg
- Department of Dermatology, Mount Sinai Hospital, New York, New York
| | - Kenneth A Katz
- Department of Dermatology, Kaiser Permanente, San Francisco, California
| |
Collapse
|
21
|
Abstract
PURPOSE Indoor tanning is associated with an increased risk of developing skin cancer. In the United States, nearly 1 in 5 white women aged 18 to 25 are indoor tanners. This study elicited beliefs about tanning indoors and quitting/cutting back on indoor tanning. DESIGN Semi-structured interviews. PARTICIPANTS AND SETTING Forty 18- to 25-year-old white females who engaged in frequent indoor tanning participated in either in-person or telephone interviews. Most were college students from southeastern Pennsylvania and Delaware. METHOD A semi-structured interview was used to elicit beliefs about indoor tanning and quitting or cutting back. Data analyses using NVivo and multiple coders identified key themes about going and quitting/cutting back on indoor tanning. RESULTS Key themes stated as reasons for indoor tanning included improving physical appearance, social acceptance, increased confidence, and happiness. The main themes identified as advantages of quitting/cutting back on indoor tanning were to decrease skin cancer risk and save money. Perceived disadvantages of quitting/cutting back included themes of concerns about being pale and a decline in self-confidence. The prospect of saving money and warm weather were seen as facilitating quitting/cutting back. CONCLUSION Findings suggest the necessity of addressing appearance concerns, psychological benefits associated with feeling more attractive, and short-term gains such as saving money. These findings provide a foundation for developing effective anti-indoor tanning communication.
Collapse
Affiliation(s)
- Karen Glanz
- 1 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- 2 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Jordan
- 3 Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - DeAnn Lazovich
- 4 School of Public Health, University of Minnesota, MN, USA
| | - Amy Bleakley
- 3 Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
22
|
Ferrucci LM, Cartmel B, Clare RA, Choy CC, Kershaw T, Leffell DJ, Mayne ST. Cross-sectional assessment of ultraviolet radiation-related behaviors among young people after a diagnosis of melanoma or basal cell carcinoma. J Am Acad Dermatol 2018; 79:149-152. [PMID: 29291957 PMCID: PMC6004335 DOI: 10.1016/j.jaad.2017.12.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 12/05/2017] [Accepted: 12/10/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Leah M Ferrucci
- Yale School of Public Health, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut.
| | - Brenda Cartmel
- Yale School of Public Health, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut
| | | | | | - Trace Kershaw
- Yale School of Public Health, New Haven, Connecticut
| | - David J Leffell
- Yale Cancer Center, New Haven, Connecticut; Yale University School of Medicine, New Haven, Connecticut
| | - Susan T Mayne
- Yale School of Public Health, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut; Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland
| |
Collapse
|
23
|
Reichrath J, Lindqvist PG, DE Gruijl FR, Pilz S, Kimball SM, Grant WB, Holick MF. A Critical Appraisal of the Recent Reports on Sunbeds from the European Commission's Scientific Committee on Health, Environmental and Emerging Risks and from the World Health Organization. Anticancer Res 2018; 38:1111-1120. [PMID: 29374748 DOI: 10.21873/anticanres.12330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/05/2017] [Accepted: 12/18/2017] [Indexed: 11/10/2022]
Abstract
The European Commission's Scientific Committee on Health, Environmental and Emerging Risks and the World Health Organization recently published reports which concluded that a large proportion of melanoma and non-melanoma skin cancer is attributable to sunbed use, and that there is no need to use sunbeds as there are no health benefits and they are not needed to achieve an optimal vitamin D level. The overall conclusion from both bodies was that there is no safe limit for UV irradiance from sunbeds. We are, however, deeply concerned that these assessments appear to be based on an incomplete, unbalanced and non-critical evaluation of the literature. Therefore, we rebut these conclusions by addressing the incomplete analysis of the adverse health effects of UV and sunbed exposure (what is 'safe'?) and the censored representation of beneficial effects, not only but especially from vitamin D production. The stance taken by both agencies is not sufficiently supported by the data and in particular, current scientific knowledge does not support the conclusion sunbed use increases melanoma risk.
Collapse
Affiliation(s)
- Jörg Reichrath
- Center for Clinical and Experimental Photodermatology, The Saarland University Hospital, Homburg, Germany .,Department of Dermatology, The Saarland University Hospital, Homburg, Germany
| | - Pelle G Lindqvist
- Department of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Huddinge, Sweden
| | - Frank R DE Gruijl
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Samantha M Kimball
- Department of Research, Pure North S'Energy Foundation, Calgary, Canada.,St. Mary's University, Calgary, Canada
| | - William B Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA, U.S.A
| | | |
Collapse
|
24
|
Abstract
Indoor tanning leads to melanoma, the fifth most common cancer in the USA. The highest rate of indoor tanning is among young women whose exposure to tanned images in the media is linked to protanning attitudes. This study evaluated the efficacy of a media literacy intervention for reducing young women's indoor tanning. Intervention participants analyzed the content and functions of the media influencing protanning attitudes and produced counter-messages to help themselves and peers resist harmful media effects. The message production was of two types: digital argument production or digital story production. The control group received assessments only. This three-group randomized design involved 26 sorority chapters and 247 members in five Midwestern states where indoor tanning is prevalent. At 2- and 6-month follow-up assessments, those in the two intervention conditions were less likely to be indoor tanners (p = .033) and reported lower indoor tanning intentions (p = .002) compared to those in the control condition. No difference between the two intervention groups was found for behavior. Although the argument group exhibited slightly weaker indoor tanning intentions than the story group, the difference was not significant. The results provide the first evidence of the efficacy of a media literacy intervention for indoor tanning reduction. Implications for participative engagement interventions are discussed.
Collapse
Affiliation(s)
- Hyunyi Cho
- Corresponding author Hyunyi Cho, School of Communication, The Ohio State University 154 N. Oval Mall Columbus, OH 43210 Phone: 614-247-1691,
| | | | | | | |
Collapse
|
25
|
Nahar VK, Rosenthal M, Lemon SC, Kane K, Cheng J, Oleski JL, Li W, Hillhouse JJ, Pagoto SL. Youth access to indoor tanning salons in urban versus rural/suburban communities. Photodermatol Photoimmunol Photomed 2017; 34:112-116. [PMID: 29080373 DOI: 10.1111/phpp.12364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND/PURPOSE Research suggests that youth proximity to tanning salons may promote use; however, little is known about tanning salon proximity to schools. We assessed the proximity of tanning salons to schools in urban versus rural/suburban communities across Worcester County, Massachusetts (population > 800K). To put findings in context, we compared school proximity to tanning salons to school proximity to McDonald's restaurants, a large franchise that also caters to young people. MATERIALS & METHODS Accessibility was measured by ArcGIS 10.2 Network Analyzer (ESRI, Redlands, CA, USA) and the most current road network data layer from Massachusetts Department of Transportation (MassDOT). RESULTS A total of 145 schools were observed in the study area, of which about 39% of schools were within 1 mile from a tanning salon. Urban schools (53.41%) had a higher proportion within 1 mile of a tanning salon than rural/suburban schools (17.54%; P < .001). More schools (39.31%) were within 1 mile of a tanning salon than schools within 1 mile of a McDonald's (22.70%; P < .001). CONCLUSIONS Schools may be particularly impactful for implementing skin cancer prevention programing.
Collapse
Affiliation(s)
- Vinayak K Nahar
- Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN, USA.,Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Meagen Rosenthal
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, USA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kevin Kane
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jie Cheng
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jessica L Oleski
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Wenjun Li
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Joel J Hillhouse
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|
26
|
Hay JL, Riley KE, Geller AC. Tanning and Teens: Is Indoor Exposure the Tip of the Iceberg? Cancer Epidemiol Biomarkers Prev 2017; 26:1170-1174. [PMID: 28765337 PMCID: PMC5626009 DOI: 10.1158/1055-9965.epi-17-0095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/03/2017] [Accepted: 04/19/2017] [Indexed: 01/27/2023] Open
Abstract
Because of recent state regulations and the reduced availability of free-standing tanning salons, indoor tanning (IT) prevalence is beginning to decline. This may lead to unintended consequences, such as increases in outdoor intentional tanning. We advance a series of research directions to track and intervene to address all forms of intentional tanning. First, we advocate for enforcement of IT regulation and encourage collection of data on tanning salon compliance and alternative IT strategies. Second, we suggest questions about outdoor and IT should be included in national surveys. Third, we need to understand the potentially complex patterns of indoor and outdoor tanning that may exist among those who tan. Fourth, research examining changing motivations for intentional tanning is needed. Finally, IT intervention studies should include outdoor tanning as an outcome to examine the effect of interventions on these related risk behaviors. These advances will ensure the development of novel interventions to address intentional tanning through multiple routes, and to avoid any unintended negative consequence of IT regulation. The promising downward direction of IT use in the United States should now lead the public health field to sharpen its focus on outdoor tanning. Cancer Epidemiol Biomarkers Prev; 26(8); 1170-4. ©2017 AACR.
Collapse
Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Kristen E Riley
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
27
|
Abstract
Indoor tanning (IT) increases the risks of skin cancer, but evidence on how to design health education messaging targeting IT among young adult women remains limited. This study investigated the effects of theory-guided gain-, loss-, and balanced-framed IT prevention messages. Young adult women ages 18-30 who indoor tan (n = 552, mean age = 24.9 years [standard deviation = 3.1]) were recruited online, completed pre-exposure measures, and were randomized to view a gain-, loss-, or balanced-framed message. Participants completed post-exposure measures of message response (emotional response, message receptivity), IT risk (perceived severity, susceptibility), and efficacy (self-efficacy, perceived benefits of avoiding IT) beliefs, and IT behavioral intentions. Loss- and balanced-framed messages promoted significantly greater emotional response and message receptivity and lower IT behavioral intentions than gain-framed messages. The effects of loss- and balanced-framed messages on IT behavioral intentions were mediated by greater emotional response and message receptivity compared with the gain-framed message. These results can inform the development of public health education campaigns to prevent and reduce IT among young adult women. Future research can build from these findings by investigating additional message themes and tailoring strategies to maximize their effects, examining the effects of framed messages prospectively, and investigating ways to enhance message receptivity, such as through novel message delivery channels (e.g., mobile devices).
Collapse
Affiliation(s)
- Darren Mays
- Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, 3300 Whitehaven Street NW, Suite 4100, Washington, DC 20007, USA
- Correspondence to: D. Mays.
| | - W. Douglas Evans
- Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue, NW, 2 floor, Washington, DC 20037, USA
| |
Collapse
|
28
|
Abstract
Purpose of the review To provide a synopsis of recent research advances in the epidemiology of keratinocyte carcinoma (KC), with a focus on indoor tanning and known risk factors for other forms of cancer such as cigarette smoking and alcohol drinking. Recent findings The evidence is strong enough to infer that use of UVR-emitting indoor tanning devices cause KC. Epidemiologic studies of cigarette smoking, alcohol drinking, and menopausal hormone therapy all show some suggestion for increased risk of KC but the evidence is not yet strong enough to determine if there is a true etiologic role. Body mass index is clearly inversely associated with KC risk but this is more likely to be due to lower UVR exposure in overweight and obese individuals than it is due to a true etiologic role. Summary The epidemic of KC continues unabated, and the causal role of indoor tanning is contributing to this unfavorable trend in KC incidence rates. Advances in understanding the etiology of KC should not divert attention away from the fact that the primary public health strategy to prevent KC is known: minimize population exposure to UVR from the sun and from UVR-emitting indoor tanning devices, particularly among those with sun-sensitive phenotypes.
Collapse
|
29
|
Hoel DG. Commercial tanning salons and melanoma risk. Dermatoendocrinol 2017; 9:e1270485. [PMID: 28405266 PMCID: PMC5386099 DOI: 10.1080/19381980.2016.1270485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 11/29/2016] [Accepted: 12/02/2016] [Indexed: 11/17/2022]
Abstract
There have been many case-control studies of melanoma and the use of indoor tanning equipment. A recent meta analysis of 8 credible studies in North America estimated an overall significant odds ratio of 1.23. Three of these 8 studies also reported separately on commercial use and home use of indoor tanning equipment. For home use the overall odds ratio was a significant 1.53 while for commercial use there was a non significant 1.05.
Collapse
Affiliation(s)
- David G Hoel
- Department of Public Health Sciences, Medical University of South Carolina , Charleston, SC, USA
| |
Collapse
|
30
|
Wright CY, Albers PN, Reeder AI, Mathee A. Sunbeds and skin cancer risk: quantifying a baseline estimate of sunbed facilities in South Africa prior to implementation of sunbed regulations. Pan Afr Med J 2017; 26:188. [PMID: 28674581 PMCID: PMC5483372 DOI: 10.11604/pamj.2017.26.188.10176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/16/2016] [Indexed: 11/21/2022] Open
Abstract
Introduction In 2009, ultraviolet-emitting tanning devices, i.e. sunbeds and tanning booths, were officially classified as carcinogenic to human health (Group 1) by the International Agency for Research on Cancer. Methods Here, we aim to estimate South African-based facilities with indoor tanning services advertised in the printed Yellow Pages and online in two directories. Printed Yellow Pages telephone directory beauty salon facilities listings (2010-14) for all provinces were examined and those mentioning "sunbed" and/or "tanning bed" recorded. Beauty/spa facilities were also identified using two sunbed listing webpages. Results A total of 40 web-advertised facilities had a sunbed. Beauty facilities in the Yellow Pages specifically mentioning sunbeds declined by 62% between 2010 (n=53) and 2014 (n=20). Gauteng had the highest number of facilities (n=25) with a sunbed. Facilities with sunbeds exist in South Africa, as evidenced by the Yellow Pages and web-advertised data, but their true prevalence remains largely unknown. It is likely that online and walk-by advertising is increasingly more common than print. Conclusion Given that sunbeds may likely soon become regulated in South Africa, further research is needed to better quantify sunbed provision, determine advice provided by facility operators to new users, investigate whether age restrictions or limits exist for sunbed use, and describe typical patterns of sunbed use in South Africa.
Collapse
Affiliation(s)
- Caradee Yael Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,Department of Geography, Geo-informatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Patricia Nicole Albers
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Anthony Ivor Reeder
- Cancer Society Social and Behavioural Research Unit, University of Otago, Dunedin School of Medicine, New Zealand
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,Faculty of Health Sciences, University of Johannesburg, South Africa
| |
Collapse
|
31
|
Ghiasvand R, Rueegg CS, Weiderpass E, Green AC, Lund E, Veierød MB. Indoor Tanning and Melanoma Risk: Long-Term Evidence From a Prospective Population-Based Cohort Study. Am J Epidemiol 2017; 185:147-156. [PMID: 28077359 DOI: 10.1093/aje/kww148] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 09/29/2016] [Indexed: 12/31/2022] Open
Abstract
Indoor tanning is associated with increased risk of melanoma, but most evidence comes from case-control studies. Using data from the Norwegian Women and Cancer Study, a large prospective cohort study, we investigated the associations of age at initiation of indoor tanning, duration of tanning-device use, and dose response with melanoma risk and examined the role of indoor tanning in age at melanoma diagnosis. We used Poisson regression to estimate relative risks and 95% confidence intervals for the relationship of indoor tanning to melanoma risk and linear regression to examine age of indoor tanning initiation in relation to age at diagnosis. During follow-up of 141,045 women (1991-2012; mean duration follow-up = 13.7 years), 861 women were diagnosed with melanoma. Melanoma risk increased with increasing cumulative number of tanning sessions (for highest tertile of use vs. never use, adjusted relative risk = 1.32, 95% confidence interval (CI): 1.08, 1.63); P-trend = 0.006. Age at initiation <30 years was associated with a higher risk in comparison with never use (adjusted relative risk = 1.31, 95% CI: 1.07, 1.59). Moreover, women who started indoor tanning prior to 30 years of age were 2.2 years (95% CI: 0.9, 3.4) younger at diagnosis, on average, than never users. This cohort study provides strong evidence of a dose-response association between indoor tanning and risk of melanoma and supports the hypothesis that vulnerability to the harmful effects of indoor tanning is greater at a younger age.
Collapse
Affiliation(s)
- Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Blindern,Oslo, Norway
| | - Corina S Rueegg
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Cancer and Population studies, Brisbane, QLD, Australia; CRUK Manchester Institute and University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Eiliv Lund
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| |
Collapse
|
32
|
Berwick M, Doré JF. Invited Commentary: Indoor Tanning-A Melanoma Accelerator? Am J Epidemiol 2017; 185:157-159. [PMID: 28077360 DOI: 10.1093/aje/kww149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 09/30/2016] [Indexed: 11/14/2022] Open
Abstract
In this issue of the Journal, Ghiasvand et al. (Am J Epidemiol. 2017;185(3):147-156) present results from a longitudinal study of the association between indoor tanning and melanoma in a large cohort of Norwegian women. These new data further support previous findings on the damaging effects of tanning bed exposure on women, particularly young women. The authors present compelling evidence that early exposure to tanning beds advances the date of diagnosis of melanoma by at least 2 years. With a strong design and a large cohort followed for a mean of 13.7 years, this study lends additional support to previous evidence of the negative effects of tanning beds and provides further justification for stronger policy initiatives designed to reduce tanning bed use among young women.
Collapse
Affiliation(s)
- Marianne Berwick
- Departments of Internal Medicine and Dermatology, School of Medicine, University of New Mexico, MSC10 5550, Albuquerque, NM 87131
| | - Jean-François Doré
- Centre de Recherche en Cancérologie de Lyon, UMR Inserm U1052 - CNRS U5286, Lyon, France
| |
Collapse
|
33
|
Carcioppolo N, Orrego Dunleavy V, Yang Q. How Do Perceived Descriptive Norms Influence Indoor Tanning Intentions? An Application of the Theory of Normative Social Behavior. Health Commun 2017; 32:230-239. [PMID: 27230254 PMCID: PMC5278634 DOI: 10.1080/10410236.2015.1120697] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Indoor tanning bed use is highly influenced by perceived norms about a tanned appearance. The theory of normative social behavior (TNSB) details the many ways in which norms can impact intentions and behavior, but has never been assessed in the context of indoor tanning. Considering this, we conducted a survey among female university students (N = 274) to determine the extent to which the TNSB predicted intentions to use indoor tanning beds. Overall, the path model predicted about 46% of the variance in intentions, and the majority of significant indirect effects were witnessed through the outcome expectation variables included in the TNSB, suggesting that these may be the most salient mechanisms-as predicted by the TNSB-through which norms can impact tanning intentions. In light of these results, theoretical and practical implications are discussed, and specific recommendations are given to extend the predictive utility of the TNSB in the context of indoor tanning.
Collapse
Affiliation(s)
| | | | - Qinghua Yang
- b Annenberg School for Communication , University of Pennsylvania
| |
Collapse
|
34
|
Evans WD, Mays D. Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study. JMIR Mhealth Uhealth 2016; 4:e137. [PMID: 28007691 PMCID: PMC5216257 DOI: 10.2196/mhealth.6493] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 09/19/2016] [Accepted: 12/15/2016] [Indexed: 01/05/2023] Open
Abstract
Background Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. Objective The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. Methods We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Results Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t6=–2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t20=1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. Conclusions This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages.
Collapse
Affiliation(s)
- William D Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Georgetown University, Washington, DC, United States
| |
Collapse
|
35
|
Guy GP, Zhang Y, Ekwueme DU, Rim SH, Watson M. The potential impact of reducing indoor tanning on melanoma prevention and treatment costs in the United States: An economic analysis. J Am Acad Dermatol 2016; 76:226-233. [PMID: 27939556 DOI: 10.1016/j.jaad.2016.09.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/06/2016] [Accepted: 09/22/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Indoor tanning is associated with an increased risk of melanoma. The US Food and Drug Administration proposed prohibiting indoor tanning among minors younger than 18 years. OBJECTIVE We sought to estimate the health and economic benefits of reducing indoor tanning in the United States. METHODS We used a Markov model to estimate the expected number of melanoma cases and deaths averted, life-years saved, and melanoma treatment costs saved by reducing indoor tanning. We examined 5 scenarios: restricting indoor tanning among minors younger than 18 years, and reducing the prevalence by 20%, 50%, 80%, and 100%. RESULTS Restricting indoor tanning among minors younger than 18 years was estimated to prevent 61,839 melanoma cases, prevent 6735 melanoma deaths, and save $342.9 million in treatment costs over the lifetime of the 61.2 million youth age 14 years or younger in the United States. The estimated health and economic benefits increased as indoor tanning was further reduced. LIMITATIONS Limitations include the reliance on available data and not examining compliance to indoor tanning laws. CONCLUSIONS Reducing indoor tanning has the potential to reduce melanoma incidence, mortality, and treatment costs. These findings help quantify and underscore the importance of continued efforts to reduce indoor tanning and prevent melanoma.
Collapse
Affiliation(s)
- Gery P Guy
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Yuanhui Zhang
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Donatus U Ekwueme
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sun Hee Rim
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meg Watson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
36
|
Pagoto SL, Baker K, Griffith J, Oleski JL, Palumbo A, Walkosz BJ, Hillhouse J, Henry KL, Buller DB. Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e228. [PMID: 27899339 PMCID: PMC5147712 DOI: 10.2196/resprot.6624] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/25/2016] [Accepted: 10/28/2016] [Indexed: 12/13/2022] Open
Abstract
Background Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. Objective This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers. Methods The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning, teenage daughters’ perception of their mothers’ permissiveness, and indoor tanning by both mothers and daughters. Results The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019. Conclusions This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. ClinicalTrial Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE).
Collapse
Affiliation(s)
- Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Katie Baker
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | | | - Jessica L Oleski
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Ashley Palumbo
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | | | - Joel Hillhouse
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, United States.,Colorado School of Public Health, Colorado State University, Fort Collins, CO, United States
| | | |
Collapse
|
37
|
Tripp MK, Watson M, Balk SJ, Swetter SM, Gershenwald JE. State of the science on prevention and screening to reduce melanoma incidence and mortality: The time is now. CA Cancer J Clin 2016; 66:460-480. [PMID: 27232110 PMCID: PMC5124531 DOI: 10.3322/caac.21352] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Answer questions and earn CME/CNE Although overall cancer incidence rates are decreasing, melanoma incidence rates continue to increase about 3% annually. Melanoma is a significant public health problem that exacts a substantial financial burden. Years of potential life lost from melanoma deaths contribute to the social, economic, and human toll of this disease. However, most cases are potentially preventable. Research has clearly established that exposure to ultraviolet radiation increases melanoma risk. Unprecedented antitumor activity and evolving survival benefit from novel targeted therapies and immunotherapies are now available for patients with unresectable and/or metastatic melanoma. Still, prevention (minimizing sun exposure that may result in tanned or sunburned skin and avoiding indoor tanning) and early detection (identifying lesions before they become invasive or at an earlier stage) have significant potential to reduce melanoma incidence and melanoma-associated deaths. This article reviews the state of the science on prevention and early detection of melanoma and current areas of scientific uncertainty and ongoing debate. The US Surgeon General's Call to Action to Prevent Skin Cancer and US Preventive Services Task Force reviews on skin cancer have propelled a national discussion on melanoma prevention and screening that makes this an extraordinary and exciting time for diverse disciplines in multiple sectors-health care, government, education, business, advocacy, and community-to coordinate efforts and leverage existing knowledge to make major strides in reducing the public health burden of melanoma in the United States. CA Cancer J Clin 2016;66:460-480. © 2016 American Cancer Society.
Collapse
Affiliation(s)
- Mary K Tripp
- Instructor, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Meg Watson
- Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sophie J Balk
- Attending Pediatrician, Children's Hospital at Montefiore, and Professor of Clinical Pediatrics, Albert Einstein College of Medicine, Bronx, NY
| | - Susan M Swetter
- Professor, Department of Dermatology, and Director, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, Stanford, CA
- Professor and Assistant Chief, Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jeffrey E Gershenwald
- Dr. John M. Skibber Professor, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Professor, Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Medical Director, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX
- Co-Leader, Melanoma Moon Shot, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
38
|
Carcioppolo N, Chudnovskaya EV, Martinez Gonzalez A, Stephan T. In-group rationalizations of risk and indoor tanning: A textual analysis of an online forum. Public Underst Sci 2016; 25:627-636. [PMID: 25550403 DOI: 10.1177/0963662514564930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Unlike other health behaviors, there does not appear to be a strong relationship between perceived skin cancer risk and reduction or cessation of indoor tanning bed use. This study seeks to address this inconsistency by determining how indoor tanning bed users rationalize skin cancer risk with their tanning behavior. Qualitative textual analysis of indoor tanning message board posts (N = 330) revealed varied perceptions of risk, including acknowledging the risk of indoor tanning; denying or downplaying risk, often citing perceived health benefits associated with tanning; blaming outside forces for cancer, such as lotion or genetics; and fatalistic beliefs about cancer. These results highlight the nuanced relationship between perceived skin cancer risk and indoor tanning bed use.
Collapse
Affiliation(s)
- Nick Carcioppolo
- University of Miami, USAUniversity of Illinois at Urbana-Champaign, USAUniversity of Miami, USA
| | | | | | | |
Collapse
|
39
|
Mansh M, Arron ST. Indoor tanning and melanoma: are gay and bisexual men more at risk? Melanoma Manag 2016; 3:89-92. [PMID: 30190876 DOI: 10.2217/mmt-2015-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 11/11/2015] [Indexed: 11/21/2022] Open
Affiliation(s)
- Matthew Mansh
- Department of Internal Medicine, California Pacific Medical Center, San Francisco, CA 94115, USA.,Department of Internal Medicine, California Pacific Medical Center, San Francisco, CA 94115, USA
| | - Sarah T Arron
- Department of Dermatology, University of California, San Francisco, CA 94143, USA.,Dermatology Service, San Francisco Veteran Affairs Medical Center, San Francisco, CA 94121, USA.,Department of Dermatology, University of California, San Francisco, CA 94143, USA.,Dermatology Service, San Francisco Veteran Affairs Medical Center, San Francisco, CA 94121, USA
| |
Collapse
|
40
|
Wang SS, Luo J, Cozen W, Lu Y, Halley-Sullivan J, Voutsinas J, Zhong C, Song J, Lacey JV, Weisenburger D, Bernstein L. Sun sensitivity, indoor tanning and B-cell non-Hodgkin lymphoma risk among Caucasian women in Los Angeles County. Br J Haematol 2016; 177:153-156. [PMID: 27030403 DOI: 10.1111/bjh.14051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/15/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Sophia S Wang
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and the Beckman Research Institute, Duarte, CA, USA
| | - Jianning Luo
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and the Beckman Research Institute, Duarte, CA, USA
| | - Wendy Cozen
- Division of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yani Lu
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and the Beckman Research Institute, Duarte, CA, USA
| | - Jane Halley-Sullivan
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and the Beckman Research Institute, Duarte, CA, USA
| | - Jenna Voutsinas
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and the Beckman Research Institute, Duarte, CA, USA
| | - Charlie Zhong
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and the Beckman Research Institute, Duarte, CA, USA
| | - Joo Song
- Division of Pathology, City of Hope Medical Center, Duarte, CA, USA
| | - James V Lacey
- Division of Pathology, City of Hope Medical Center, Duarte, CA, USA
| | | | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and the Beckman Research Institute, Duarte, CA, USA
| |
Collapse
|
41
|
Stapleton JL, Manne SL, Greene K, Darabos K, Carpenter A, Hudson SV, Coups EJ. Sociocultural experiences, body image, and indoor tanning among young adult women. J Health Psychol 2016; 22:1582-1590. [PMID: 26929174 DOI: 10.1177/1359105316631198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The purpose of this survey study was to evaluate a model of body image influences on indoor tanning behavior. Participants were 823 young adult women recruited from a probability-based web panel in the United States. Consistent with our hypothesized model, tanning-related sociocultural experiences were indirectly associated with lifetime indoor tanning use and intentions to tan as mediated through tan surveillance and tan dissatisfaction. Findings suggest the need for targeting body image constructs as mechanisms of behavior change in indoor tanning behavioral interventions.
Collapse
|
42
|
Gellén E, Janka E, Tamás I, Ádám B, Horkay I, Emri G, Remenyik É. Pigmented naevi and sun protection behaviour among primary and secondary school students in an Eastern Hungarian city. Photodermatol Photoimmunol Photomed 2015; 32:98-106. [PMID: 26477694 DOI: 10.1111/phpp.12219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The most important risk factors for malignant melanoma are skin type I or II, large number of atypical naevi and a history of sunburn in childhood and adolescence. METHODS A cross-sectional study was performed to assess skin type, number of pigmented lesions and sun protection behaviour in 1157 12- to 19-year-old Hungarian students at 20 primary and secondary schools in Debrecen, Hungary. After receiving dermatological training, 18 school doctors examined the students' skin. A questionnaire was completed by the students with the assistance of their parents about sun protection, sunburns and the use of sunbed. Data from 612 questionnaires were evaluated. RESULTS Based on the doctors' evaluation, most of the pupils were classified as having skin type II and majority of them had 5-20 naevi, particularly on the trunk. Based on the student's response, 5.2% purposely sunbathed daily, 10.1% did not use any form of sun protection, 32.2% wore sun-protective clothing and 65.7% applied sunscreen generally. 6.9% used sunbed, and 74.0% previously experienced serious sunburn at least once. Indoor tanning statistically correlated with the number of melanocytic naevi. CONCLUSION A high prevalence of sunburn was reported by the students and some of them did not apply any sun protection methods but used sunbed at a critical age for developing melanoma at a later time. These data highlight the importance of educating children and parents about appropriate sun protection.
Collapse
Affiliation(s)
- Emese Gellén
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Eszter Janka
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildikó Tamás
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs Ádám
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.,Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Irene Horkay
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gabriella Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Éva Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| |
Collapse
|
43
|
Molinaro AM, Ferrucci LM, Cartmel B, Loftfield E, Leffell DJ, Bale AE, Mayne ST. Indoor tanning and the MC1R genotype: risk prediction for basal cell carcinoma risk in young people. Am J Epidemiol 2015; 181:908-16. [PMID: 25858289 PMCID: PMC4445390 DOI: 10.1093/aje/kwu356] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 12/01/2014] [Indexed: 12/25/2022] Open
Abstract
Basal cell carcinoma (BCC) incidence is increasing, particularly in young people, and can be associated with significant morbidity and treatment costs. To identify young individuals at risk of BCC, we assessed existing melanoma or overall skin cancer risk prediction models and built a novel risk prediction model, with a focus on indoor tanning and the melanocortin 1 receptor gene, MC1R. We evaluated logistic regression models among 759 non-Hispanic whites from a case-control study of patients seen between 2006 and 2010 in New Haven, Connecticut. In our data, the adjusted area under the receiver operating characteristic curve (AUC) for a model by Han et al. (Int J Cancer. 2006;119(8):1976-1984) with 7 MC1R variants was 0.72 (95% confidence interval (CI): 0.66, 0.78), while that by Smith et al. (J Clin Oncol. 2012;30(15 suppl):8574) with MC1R and indoor tanning had an AUC of 0.69 (95% CI: 0.63, 0.75). Our base model had greater predictive ability than existing models and was significantly improved when we added ever-indoor tanning, burns from indoor tanning, and MC1R (AUC = 0.77, 95% CI: 0.74, 0.81). Our early-onset BCC risk prediction model incorporating MC1R and indoor tanning extends the work of other skin cancer risk prediction models, emphasizes the value of both genotype and indoor tanning in skin cancer risk prediction in young people, and should be validated with an independent cohort.
Collapse
Affiliation(s)
- Annette M. Molinaro
- Correspondence to Dr. Annette M. Molinaro, Department of Neurosurgery, University of California, San Francisco, 400 Parnassus Avenue, Room A 808, San Francisco, CA 94143-0372 (e-mail: )
| | | | | | | | | | | | | |
Collapse
|
44
|
Bowman DM, Lewis RC, Lee MS, Yao CJ. The Growing Public Health Challenges of Exposure to Ultraviolet Radiation From Use of Indoor Tanning Devices in the United States. New Solut 2015; 25:164-71. [PMID: 25995373 DOI: 10.1177/1048291115586416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ultraviolet radiation is recognized as a human carcinogen by the International Agency for Research on Cancer, the world's authority on cancer research. In particular, exposure to ultraviolet radiation can lead to melanoma of the skin, which is the deadliest form of skin cancer in the United States. Yet despite the significant public health burden that is associated with skin cancer in the United States, each year over a million Americans engage in indoor tanning where exposure to artificial ultraviolet radiation occurs. In this article, we argue for an immediate ban on the use of commercial indoor tanning by minors and, based on international precedents, the phasing out of all commercial tanning operations in the United States. We consider the use of indoor tanning devices in the United States, epidemiological data on indoor tanning devices and cancer, regulation of tanning devices, and scientific evidence for increased government intervention.
Collapse
Affiliation(s)
- Diana M Bowman
- Department of Health Management & Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA Risk Science Center, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ryan C Lewis
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Maximilian S Lee
- Department of Health Management & Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Catherine J Yao
- Department of Health Management & Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA University of Michigan Law School, Ann Arbor, MI, USA
| |
Collapse
|
45
|
McWhirter JE, Hoffman-Goetz L. Coverage of skin cancer and recreational tanning in North American magazines before and after the landmark 2006 International Agency for Research on Cancer report. BMC Public Health 2015; 15:169. [PMID: 25884779 PMCID: PMC4342877 DOI: 10.1186/s12889-015-1511-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 02/09/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Skin cancer is an increasingly important global public health problem. Mass media is a key source of skin cancer information. We examined how media coverage of skin cancer has changed over time as a consequence of the release of a key public health report from the International Agency for Research on Cancer (IARC) in 2006, which linked ultraviolet (UV) radiation from indoor tanning and skin cancer. METHODS A directed content analysis of skin cancer and tanning coverage in 29 popular North American magazines (2001-2012) examined reporting of skin cancer risk factors, UV behaviors, and early detection in article text (n = 761) and images (n = 1267). Chi-square and correlational analyses were used determine whether coverage changed in relation to the 2006 IARC report. RESULTS The total volume of articles about skin cancer and tanning increased modestly after the IARC report (χ (2) = 4.57, df = 1, p < .05); however, key IARC report messages (e.g., avoid indoor tanning, UV as a risk factor) were no more likely to be reported after compared to before the report. There were virtually no changes in the percentage of coverage for both risk factors and early detection information over time. There were some changes in the percentage of coverage about UV behaviors after the IARC report, but these variables were not directly related to the report. Magazines were more likely to encourage sunscreen use (χ (2) = 11.55, df = 1, p < .01) and less likely to promote the tanned look as attractive (χ (2) = 9.72, df = 1, p < .01) after the IARC report. It also became less common for magazines to promote sun avoidance (χ (2) = 6.82, df = 1, p < .01) and use of sunless tanners (χ (2) = 7.46, df = 1, p < .01) after the report. CONCLUSIONS Despite a modest increase in volume of coverage post-IARC report, key messages from the report were not taken up by the media. While there have been some improvements in magazine reporting, there is a need for more effective dissemination of public health messages about skin cancer and tanning.
Collapse
Affiliation(s)
- Jennifer E McWhirter
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue W, Ontario, Canada, N2L 3G1.
| | - Laurie Hoffman-Goetz
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue W, Ontario, Canada, N2L 3G1.
| |
Collapse
|
46
|
Quinn M, Alamian A, Hillhouse J, Scott C, Turrisi R, Baker K. Prevalence and Correlates of Indoor Tanning and Sunless Tanning Product Use among Female Teens in the United States. Prev Med Rep 2015; 2:40-43. [PMID: 25621199 PMCID: PMC4302332 DOI: 10.1016/j.pmedr.2014.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Indoor tanning (IT) before the age of 35 increases melanoma risk by 75%. Nevertheless, IT and sunless tanning product (STP) use have gained popularity among youth. However, there are limited data on the prevalence and sociodemographic correlates of both IT and STP use in a representative sample of American teens. METHODS Teenage females (N=778) aged 12-18 years were recruited as part of an on-going longitudinal study conducted between May 2011 and May 2013. Descriptive statistics explored IT and STP usage in teen females at baseline. Logistic regression was used to determine sociodemographic correlates of IT and STP use. RESULTS Approximately 16% of female teens engaged in IT behavior and 25% engaged in using STPs. Female teens living in non-metropolitan areas were 82% more likely to indoor tan compared to those in metropolitan areas (OR=1.82, 95% CI:1.07-3.10). Age, geographic regions, and race increased the likelihood of IT and STP use. CONCLUSIONS Results indicate a significant proportion of teen females engage in IT and STP use. There was evidence that in teens that have never used IT before, STP use precedes IT initiation. Given the evidence for increased IT in rural populations, research focused on rural tanning bed use is needed.
Collapse
Affiliation(s)
- Megan Quinn
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | - Arsham Alamian
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | - Joel Hillhouse
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | - Colleen Scott
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | - Rob Turrisi
- Prevention Research Center and Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, United
| | - Katie Baker
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| |
Collapse
|
47
|
Herrmann JL, Cunningham R, Cantor A, Elewski BE, Elmets CA. Tanning accelerators: prevalence, predictors of use, and adverse effects. J Am Acad Dermatol 2014; 72:99-104. [PMID: 25458018 DOI: 10.1016/j.jaad.2014.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 10/13/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Tanning accelerators are topical products used by indoor tanners to augment and hasten the tanning process. These products contain tyrosine, psoralens, and/or other chemicals. OBJECTIVE We sought to better define the population using accelerators, identify predictors of their use, and describe any related adverse effects. METHODS This cross-sectional study surveyed 200 indoor tanners about their tanning practices and accelerator use. Primary analysis compared accelerator users with nonusers with respect to questionnaire variables. Descriptive statistics and χ(2) contingency tables were applied to identify statistically significant variables. RESULTS Of respondents, 53% used accelerators; 97% were female and 3% were male with a median age of 22 years (range: 19-67). Users were more likely to spray tan, tan frequently, and be addicted to tanning. Acne and rashes were more common in accelerator users. Adverse reactions to accelerators prevented their further use 31% of the time. LIMITATIONS A limited adult population was evaluated; exact accelerator ingredients were not examined. CONCLUSIONS Tanning accelerator users are high-risk indoor tanners who tan more frequently and who are more likely addicted to tanning. Acne and rashes are more common with these products and act as only mild deterrents to continued use. Additional research should investigate accelerators' longer-term health effects.
Collapse
Affiliation(s)
- Jennifer L Herrmann
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Rachel Cunningham
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alan Cantor
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Boni E Elewski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Craig A Elmets
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
48
|
Banerjee SC, Greene K, Yanovitzky I, Bagdasarov Z, Choi SY, Magsamen-Conrad K. Adolescent egocentrism and indoor tanning: is the relationship direct or mediated? J Youth Stud 2014; 18:357-375. [PMID: 28042281 PMCID: PMC5198897 DOI: 10.1080/13676261.2014.963536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This paper explored how imaginary audience and personal fable ideations contribute to adolescent indoor tanning intentions directly and indirectly through the way they shape pro-tanning attitude and association with peers who use tanning beds. Five hundred and ninety-five male (n = 207) and female (n = 387) adolescents, ranging in age from 11 to 19 (M = 16.87; SD = 1.34) years completed a cross-sectional survey. Measures included imaginary audience, personal fable (three dimensions: invulnerability, uniqueness, and omnipotence), pro-tanning attitude, association with peers who use tanning beds, and tanning bed use intentions. Bootstrapping analyses documented that imaginary audience ideations are indirectly associated with indoor tanning intentions through the mediation of pro-tanning attitude and association with peers who use tanning beds. Of the personal fable ideations, only invulnerability ideation is indirectly associated with indoor tanning intentions through the mediation of association with peers who use tanning beds. Design and evaluation of interventions and campaigns to reduce indoor tanning must be targeted to adolescents varying in imaginary audience ideations differently.
Collapse
Affiliation(s)
- Smita C. Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Itzhak Yanovitzky
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Zhanna Bagdasarov
- Communication and Health Issues Partnership for Education and Research, Rutgers University, New Brunswick, NJ, USA
| | - Soe Yoon Choi
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Kate Magsamen-Conrad
- Department of Communication, Bowling Green State University, Bowling Green, OH, USA
| |
Collapse
|
49
|
Ferrucci LM, Vogel RI, Cartmel B, Lazovich D, Mayne ST. Indoor tanning in businesses and homes and risk of melanoma and nonmelanoma skin cancer in 2 US case-control studies. J Am Acad Dermatol 2014; 71:882-7. [PMID: 25062934 DOI: 10.1016/j.jaad.2014.06.046] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 06/27/2014] [Accepted: 06/28/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Indoor tanning increases skin cancer risk. Beyond early research describing melanoma and sun lamps, few recent reports describe where individuals indoor tan and whether skin cancer risk varies by location (business, home-based). OBJECTIVE We sought to assess where individuals tanned indoors and skin cancer risk by tanning device location. METHODS Multivariate logistic regression was conducted in 2 US case-control studies of melanoma (1161 cases, 1083 controls, ages 25-59 years) and early-onset basal cell carcinoma (375 cases, 382 controls, age<40 years) conducted between 2004 and 2010. RESULTS Most indoor tanners (86.4%-95.1%), especially younger individuals, tanned exclusively in businesses. Persons who used indoor tanning exclusively in businesses were at increased risk of melanoma (odds ratio 1.82, 95% confidence interval 1.47-2.26) and basal cell carcinoma (odds ratio 1.69, 95% confidence interval 1.15-2.48) compared with non-users. Melanoma risk was also increased in the small number who reported tanning indoors only at home relative to non-users (odds ratio 4.14, 95% confidence interval 1.75-9.78); 67.6% used sun lamps. LIMITATIONS Self-reported tanning and potential recall bias are limitations. CONCLUSION Business-only tanning, despite claims of "safe" tanning, was positively associated with a significant risk of melanoma and basal cell carcinoma. Home tanning was uncommon and mostly from sun lamps, which were rarely used by younger participants. Regardless of location, indoor tanning was associated with increased risk of skin cancer.
Collapse
Affiliation(s)
- Leah M Ferrucci
- Yale School of Public Health, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut.
| | | | - Brenda Cartmel
- Yale School of Public Health, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Susan T Mayne
- Yale School of Public Health, New Haven, Connecticut; Yale Cancer Center, New Haven, Connecticut
| |
Collapse
|
50
|
Karagas MR, Zens MS, Li Z, Stukel TA, Perry AE, Gilbert-Diamond D, Sayarath V, Stephenson RS, Barton D, Nelson HH, Spencer SK. Early-onset basal cell carcinoma and indoor tanning: a population-based study. Pediatrics 2014; 134:e4-12. [PMID: 24958589 PMCID: PMC4067637 DOI: 10.1542/peds.2013-3559] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Indoor tanning with UV radiation-emitting lamps is common among adolescents and young adults. Rising incidence rates of basal cell carcinoma (BCC) have been reported for the United States and elsewhere, particularly among those diagnosed at younger ages. Recent epidemiologic studies have raised concerns that indoor tanning may be contributing to early occurrence of BCC, and younger people may be especially vulnerable to cancer risk associated with this exposure. Therefore, we sought to address these issues in a population-based case-control study from New Hampshire. METHODS Data on indoor tanning were obtained on 657 cases of BCC and 452 controls ≤50 years of age. RESULTS Early-onset BCC was related to indoor tanning, with an adjusted odds ratio (OR) of 1.6 (95% confidence interval, 1.3-2.1). The strongest association was observed for first exposure as an adolescent or young adult, with a 10% increase in the OR with each age younger at first exposure (OR per year of age ≤23 = 1.1; 95% confidence interval, 1.0-1.2). Associations were present for each type of device examined (ie, sunlamps, tanning beds, and tanning booths). CONCLUSIONS Our findings suggest early exposure to indoor tanning increases the risk of early development of BCC. They also underscore the importance of counseling adolescents and young adults about the risks of indoor tanning and for discouraging parents from consenting minors to this practice.
Collapse
Affiliation(s)
- Margaret R Karagas
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire;
| | - M Scot Zens
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Zhigang Li
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Therese A Stukel
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Ann E Perry
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; and
| | - Diane Gilbert-Diamond
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Vicki Sayarath
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Rita S Stephenson
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire;Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine, Hanover, New Hampshire
| | - Dorothea Barton
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; and
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Steven K Spencer
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; and
| |
Collapse
|