Critique of the International Agency for Research on Cancer meta-analyses of the association of sunbed use with risk of cutaneous malignant melanoma

Grant, William B.

doi:10.4161/derm.1.6.11461

Cited by 13 publications

(10 citation statements)

References 78 publications

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“…Although it was impossible in this study to ascertain whether suspected melanomas were confirmed as such by histopathology, this result appears to confirm the current evidence that sunbed use increases melanoma risk. In particular, our estimate was consistent with those found in previous meta-analyses assessing melanoma risk associated with ever using sunbeds: 15% by the IARC, 2 8 Like others before, 6,32 Burgard and co-workers recently raised criticisms about the association between sunbed use and melanoma risk, including limitations of individual studies (selection and recall biases, typical of case-control studies; non-adjustment for certain confounders) and lack of large randomized or prospective studies (which in the case of sunbeds would be unethical or too costly, respectively). Yet, they found similar results in their meta-analysis, even using a different statistical method.…”

Section: Discussionsupporting

confidence: 91%

“…In particular, our estimate was consistent with those found in previous meta‐analyses assessing melanoma risk associated with ever using sunbeds: 15% by the IARC, 16% (10% for Europe alone) by Colantonio et al ., 19% by Burgard et al ., 20% by Boniol et al ., 22% by Hirst et al ., and 25% by Gallagher et al . Like others before, Burgard and co‐workers recently raised criticisms about the association between sunbed use and melanoma risk, including limitations of individual studies (selection and recall biases, typical of case‐control studies; non‐adjustment for certain confounders) and lack of large randomized or prospective studies (which in the case of sunbeds would be unethical or too costly, respectively). Yet, they found similar results in their meta‐analysis, even using a different statistical method .…”

Section: Discussionmentioning

confidence: 99%

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Association of sunbed use with skin cancer risk factors in Europe: an investigation within the Euromelanoma skin cancer prevention campaign

Suppa

Gandini

Njimi

et al. 2019

Acad Dermatol Venereol

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Introduction Sunbed use has been significantly associated with increased risk of melanoma and non‐melanoma skin cancer (NMSC), but its relationship with melanoma's risk factors such as high nevus count, atypical nevi and lentigines is poorly studied. Euromelanoma is a skin cancer prevention campaign conducted all over Europe. It offers a once‐a‐year screening during which participants’ data, including sunbed use and phenotype, are collected via questionnaires. Objectives To investigate the association of sunbed use with nevus count, atypical nevi, lentigines and suspicion of skin cancer. Methods To ensure reliability of the data, we defined inclusion and exclusion criteria for countries’ eligibility for the risk analysis. Multivariate logistic regression models (including age, gender, education, skin type, family history of melanoma, personal history of skin cancer, any sun exposure and any sunscreen use) were used to calculate summary odds ratios (SORs) of each clinical endpoint for ever sunbed use. Results Overall, 227 888 individuals from 30 countries completed the Euromelanoma questionnaire. After the data quality check, 16 countries were eligible for the multivariate analysis, for a total of 145 980 participants (64.8% females; median age 43 years; 62.3% highly educated; 28.5% skin type I–II; 11.0% ever sunbed use). Ever sunbed use was independently associated with nevus count >50 [SOR = 1.05 (1.01–1.10)], atypical nevi [SOR = 1.04 (1.00–1.09)], lentigines [SOR = 1.16 (1.04–1.29)] and suspicion of melanoma [SOR = 1.13 (1.00–1.27)]. Conversely, no significant association was found between ever sunbed use and suspicion of NMSC [SOR = 1.00 (0.91–1.10)]. Conclusions Indoor tanning is significantly associated with well‐recognized risk factors for melanoma (including high nevus count, presence of atypical nevi and lentigines) as well as suspicion of melanoma within the Euromelanoma screenees. In order to reduce the prevalence of melanoma risk factors, avoidance/discontinuation of sunbed use should always be encouraged, especially but not exclusively for individuals with high‐risk phenotypes.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Association of sunbed use with skin cancer risk factors in Europe: an investigation within the Euromelanoma skin cancer prevention campaign

Suppa

Gandini

Njimi

et al. 2019

Acad Dermatol Venereol

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“…Many residents in the UK have the allele of the melanocortin receptor 1 (MC1R) gene [40] that is an important risk factor for melanoma [41]. When the five UK studies are removed, the odds ratio falls by 0.10 and is no longer statistically significant [42]. However, a recent prospective study of melanoma with respect to sunbed use in Sweden found approximately 50% increased risk of melanoma for more than 2-3 sunbed uses per week for those aged 20-39 years [43], the health benefits of solar UVB irradiance greatly outweigh this risk [36].…”

Section: Discussionmentioning

confidence: 96%

“…However, a recent prospective study of melanoma with respect to sunbed use in Sweden found approximately 50% increased risk of melanoma for more than 2-3 sunbed uses per week for those aged 20-39 years [43], the health benefits of solar UVB irradiance greatly outweigh this risk [36]. Sunbed use in Sweden was found inversely correlated with endometrial cancer and thrombotic events [42].…”

Section: Discussionmentioning

confidence: 98%

Health benefits of higher serum 25-hydroxyvitamin D levels in The Netherlands

Grant

Schuitemaker²

2010

The Journal of Steroid Biochemistry and Molecular Biology

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“…Also timing, i.e., age at first exposure, must be taken into account [73]. Considering all these complicating factors, it is no surprise that the controversy about the benefits or dangers of sunbeds continues [74,75,76,77]. …”

Section: Discussionmentioning

confidence: 99%

UV “Indices”—What Do They Indicate?

Moshammer

Simic

Haluza

2016

IJERPH

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Ultra-Violet (UV) radiation covers the spectrum of wavelengths from 100 to 400 nm. The potency and biological activity for a variety of endpoints differ by wavelength. For monitoring and communication purposes, different UV action spectra have been developed. These spectra use different weighting functions. The action spectrum for erythemal dose is the most widely used one. This erythemal dose per time or dose-rate has been further simplified into a “UV index”. Following this example, in our review we use the term “index” or (plural) “indices” in a more general description for all simplified single-value measures for any biologically effective UV dose, e.g., for human non-melanoma skin cancer and for previtamin D production rate. Ongoing discussion about the existence of an increased melanoma risk due to UV-A exposure underscores the uncertainties inherent in current weighting functions. Thus, we performed an online literature search to review the data basis for these indices, to understand their relevance for an individual, and to assess the applicability of the indices for a range of exposure scenarios. Even for natural (solar) UV, the spectral composition varies spatially and temporally. Artificial UV sources and personal protection introduce further variation to the spectral composition. Many biological effects are proposed for UV radiation. Only few endpoints have been studied sufficiently to estimate a reliable index. Weighting functions for chronic effects and most importantly for cancer endpoints have been developed in animal models, and often for proxy endpoints only. Epidemiological studies on biological effects of UV radiation should not only depend on single-value weighted UV dose estimates (indexes) but should strive for a more detailed description of the individual exposure. A better understanding of the adverse and beneficial effects of UV radiation by wavelength would also improve medical counseling and health communication regarding individual health-supportive behavior.

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Critique of the International Agency for Research on Cancer meta-analyses of the association of sunbed use with risk of cutaneous malignant melanoma

Cited by 13 publications

References 78 publications

Association of sunbed use with skin cancer risk factors in Europe: an investigation within the Euromelanoma skin cancer prevention campaign

Association of sunbed use with skin cancer risk factors in Europe: an investigation within the Euromelanoma skin cancer prevention campaign

Health benefits of higher serum 25-hydroxyvitamin D levels in The Netherlands

UV “Indices”—What Do They Indicate?

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