Indoor Tanning, Skin Cancer and the Young Female Patient: A Review of the Literature

Friedman, Blake; English, Joseph C.; Ferris, Laura K.

doi:10.1016/j.jpag.2014.07.015

Cited by 22 publications

(11 citation statements)

References 96 publications

(134 reference statements)

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“…7 12 However, the popularity of tanning, primarily among the young adult population, further promotes these unsafe sun-related behaviours. [12][13][14] Skin cancer prevention therefore remains a public health priority 4 and should principally target young adults, specifically 16-24 year olds, according to Cancer Research UK. 15 Yet, this population is less receptive to health education.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study

Kirk

Greenfield

2017

BMJ Open

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ObjectivesTo explore whether knowledge about the harms of ultraviolet radiation (UVR) influences UK university students' sun-related behaviours and examine in depth their attitudes towards: sun protection, natural and artificial tanning behaviours.DesignQualitative methodology with 15 semistructured, individual interviews. Thematic analysis using the Framework Method with analyst triangulation and member validation.SettingOne university in the West Midlands, UK.Participants15 Caucasian male (n=4) and female (n=11) students, aged 18–22 years, from a UK university. Participants were recruited using convenience sampling from the university's main campus followed by purposive sampling for: gender, course and sun-related behaviours.ResultsFive main themes emerged: (1) knowledge of UVR; (2) sun-protection practices; (3) attitudes towards tanning; (4) external influences and (5) internal influences. All students knew the associated skin cancer risks from the sun and sunbed use, but this did not appear an important influence in their sun-related behaviours. Body image strongly motivated sun-protection practices and the desire to tan naturally or artificially, across both genders. However, participants' final decision-making appeared to be influenced by their beliefs that practising known harmful sun-related behaviours would not affect them or the perceived susceptibility to sunburn. Beliefs about sunbathing and sunscreen use prompted improper use of sun protection and inadvertently caused more harmful practices. Participants' peers, family and the media had dual roles influencing the development of attitudes towards sun protection and tanning, which contributed to how participants behaved in the sun and their engagement in tanning methods.ConclusionsKnowledge about the risk of skin cancer associated with UVR did not strongly influence sun-related behaviours, whereas body image appeared as a key motivator. Attitudes towards sun protection and tanning stemmed from the media, peers and family, and particularly from childhood habits. Public health strategies may benefit from appearance-related skin cancer prevention campaigns, encouraging safer parental sun-related habits and correcting sun-related misconceptions.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study

Kirk

Greenfield

2017

BMJ Open

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“…Multiple studies have aimed to bridge this gap in evidence between prevention programs and behavioural outcomes, including by measuring program reach [12], monitoring the growing prevalence of sun protection policies and regulations [12], and analysing the association between the dose of campaign advertising and sun protection behaviour [28,31]. Moreover, the programs implemented are underpinned by a strong theoretical foundation including epidemiological evidence that UV causes skin cancer [1,39,48], evidence of the effectiveness of sun protection measures [49–53], and health promotion and behaviour change principles [12,54].…”

Section: Discussionmentioning

confidence: 99%

“…The behavioural models included the relevant weather conditions, and the sunburn model also included the mean UV Index. These covariates have significant theoretical and observed influences on the outcome variables: (i) UV has a causal effect on sunburn prevalence [2,38,39], (ii) past and present ambient temperature influence thermal comfort [40,41], and (iii) month of interview provides a measure of temporal change across the summer, which may reflect temporal changes in respondents’ outdoor activities and desire for a suntan. Note that the model predicting the proportion of respondents outdoors during peak UV hours was modelled for Sunday, given it was only possible to adjust for weather conditions on 1 weekend day.…”

Section: Methodsmentioning

confidence: 99%

Implementation of the SunSmart program and population sun protection behaviour in Melbourne, Australia: Results from cross-sectional summer surveys from 1987 to 2017

et al. 2019

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BackgroundAustralia has one of the highest skin cancer rates in the world. ‘SunSmart’ is a multi-component, internationally recognised community-wide skin cancer prevention program implemented in Melbourne, Australia, since summer 1988–1989. Following recent reductions in melanoma rates among younger Australian cohorts, the extent of behaviour change and the potential contribution of prevention programs to this decline in melanoma rates are of interest. Sun protection is a multifaceted behaviour. Measures previously applied to monitor change over time in preventive behaviour for this population focused on individual behaviours. The omission of multiple behaviours that reduce exposure to ultraviolet radiation (UV) may have led to underestimates of behaviour change, meriting further analysis of long-term trends to contribute to this debate.Methods and findingsA population-based survey was conducted in Melbourne in the summer before SunSmart commenced (1987–1988) and across summers in 3 subsequent decades (1988–2017). During summer months, residents (14–69 years) were recruited to cross-sectional weekly telephone interviews assessing their tanning attitudes, sun protection behaviour, and sunburn incidence on the weekend prior to interview. Quotas were used to ensure the sample was proportional to the population by age and sex, while younger respondents were oversampled in some years. The majority of the respondents reported their skin was susceptible to sunburn. Changes in sun protection behaviour were analysed for N = 13,285 respondents in multivariable models, cumulating surveys within decades (1987–1988: N = 1,655; 1990s: N = 5,258; 2000s: N = 3,385; 2010s: N = 2,987) and adjusting for relevant ambient weather conditions and UV levels on weekend dates. We analysed specific and composite behaviours including a novel analysis of the use of maximal sun protection, which considered those people who stayed indoors during peak UV hours together with those people well-protected when outdoors. From a low base, use of sun protection increased rapidly in the decade after SunSmart commenced. The odds of use of at least 1 sun protection behaviours on summer weekends was 3 times higher in the 1990s than pre-SunSmart (adjusted odds ratio [AOR] 3.04, 95% CI 2.52–3.68, p < 0.001). There was a smaller increase in use of maximal sun protection including shade (AOR = 1.68, 95% CI 1.44–1.97, p < 0.001). These improvements were sustained into the 2000s and continued to increase in the 2010s. Inferences about program effects are limited by the self-reported data, the absence of a control population, the cross-sectional study design, and the fact that the survey was not conducted in all years. Other potential confounders may include increasing educational attainment among respondents over time and exposure to other campaigns such as tobacco and obesity prevention.ConclusionsWith an estimated 20-year lag between sun exposure and melanoma incidence, our findings are consistent with SunSmart having contributed to the reduction in melanoma ...

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“…An understanding of the reasons behind the higher propensity for indoor tanning in women is critical if the behavior is to be successfully curtailed. This has been an area of intense study in recent years, and several high-quality reviews (Friedman et al, 2015, Holman and Watson, 2013, Levine et al, 2005, Madigan and Lim, 2016, Watson et al, 2013) outline the various factors that motivate tanning behavior. Even though an exhaustive review of the subject is beyond the scope of this discussion, the concept of physical appearance with regard to external influences will be reviewed briefly.…”

Section: Indoor Tanning Is Used Most Commonly By Young Women and Is Amentioning

confidence: 99%

Nonmelanoma skin cancer in women

Heaton

Lawrence

2019

International Journal of Women's Dermatology

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Men continue to develop nonmelanoma skin cancer (NMSC) at higher rates than women, but the epidemiologic pattern of NMSC development is evolving. We present a selective, narrative review of the literature showing that there is a trend toward a development of basal cell carcinomas in women at younger ages, and highlight potential causes of this trend. We review evidence that indoor tanning is associated with the development of NMSC and show that young women use indoor tanning more than any other age-sex group. We discuss societal factors that relate to the tanning behavior of young women. Finally, we argue that facial NMSCs may have more of a negative impact on quality of life in women than in men.

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Indoor Tanning, Skin Cancer and the Young Female Patient: A Review of the Literature

Cited by 22 publications

References 96 publications

Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study

Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study

Implementation of the SunSmart program and population sun protection behaviour in Melbourne, Australia: Results from cross-sectional summer surveys from 1987 to 2017

Nonmelanoma skin cancer in women

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