Sunbed use during adolescence and early adulthood is associated with increased risk of early‐onset melanoma

Abstract

Sunbed use is associated with increased risk of melanoma. Younger people might be more susceptible to the carcinogenic effects of ultraviolet radiation. We investigated the association between sunbed use and risk of early-onset cutaneous malignant melanoma. From the Australian Melanoma Family Study, a multicentre, population-based, case-control-family study, we analysed data for 604 cases diagnosed between ages 18 and 39 years and 479 controls. Data were collected by interview. Associations were estimated as odds ratios (ORs) using unconditional logistic regression, adjusting for age, sex, city, education, family history, skin color, usual skin response to sunlight and sun exposure. Compared with having never used a sunbed, the OR for melanoma associated with ever-use was 1.41 (95% confidence interval (CI) 1.01-1.96), and 2.01 (95% CI 1.22-3.31) for more than 10 lifetime sessions (P trend 0.01 with cumulative use). The association was stronger for earlier age at first use (P trend 0.02). The association was also stronger for melanoma diagnosed when aged 18-29 years (OR for more than 10 lifetime sessions 5 6.57, 95% CI 1.41-30.49) than for melanoma diagnosed when 30-39 years (OR 1.60, 95% CI 0.92-2.77; P interaction 0.01). Among those who had ever used a sunbed and were diagnosed between 18 and 29 years of age, three quarters (76%) of melanomas were attributable to sunbed use. Sunbed use is associated with increased risk of earlyonset melanoma, with risk increasing with greater use, an earlier age at first use and for earlier onset disease.There is mounting evidence that use of sunbeds (indoor tanning) is associated with an increased risk of melanoma at any age. However, younger people might have greater susceptibility to the carcinogenic effects of artificial ultraviolet (UV) radiation. 1 A meta-analysis of 19 studies reported that everuse of sunbeds was associated with 15% increased risk of melanoma [95% confidence interval (CI) 1.00-1.31] compared with never having used a sunbed, although there was no consistent evidence of a dose-response relation. The relative risk of melanoma was greater for those who first used a sunbed before 35 years of age (summary relative risk based on seven studies: 1.75, 95% CI 1.35-2.26). 1 Adolescents and young adults have the highest prevalence of sunbed use, estimated at about 20-40% in the United States and Sweden, 2-6 yet little is known about the association of sunbed use with melanoma diagnosed in young adults since most previous studies have recruited people with melanoma diagnosed at any age. Although the median age of diagnosis of melanoma is about 60 years, 7,8 melanoma is one of the most common cancers and leading causes of cancer death in young adults, [7][8][9] It is of public health importance to determine the risks of melanoma associated with sunbed use in younger people because this risk behavior is increasingly prevalent in developed countries including the United States and Australia, 2,4,10,11 and melanoma incidence rates continue to increase in populations of E...

A prospective, population‐based study of 40,000 women regarding host factors, UV exposure and sunbed use in relation to risk and anatomic site of cutaneous melanoma

“…In our prospective study design we wanted to test if artificial UVR exposure was associated with an increased risk for CM, as not only the recent review from IARC 21 concluded that also artificial UVR, e.g., from sunbeds and sun lamps, is carcinogenic. Recent studies 4,7 as well as older studies 9,10,19,20 have shown that artificial UVR exposure could be associated with increased risk for CM. Nevertheless, limitations of several published studies have been the difficulty to properly adjust for natural UVR (sun) exposure in the statistical analyses.…”

“…Nevertheless, limitations of several published studies have been the difficulty to properly adjust for natural UVR (sun) exposure in the statistical analyses. Lazovich et al 7 as well as Cust et al 4 did, however, try to avoid this limitation by rigorously adjusting for sun exposure, and both found an association between CM and UVR exposure from sunbeds. The precise pathogenesis of CM is still unknown, but the carcinogenicity of UVB have been ascribed to direct DNA damage, while the probable carcinogenicity of UVA have been explained by damage to DNA by indirect effects (reactive oxygen species, photoreactions and photoproducts).…”

Sunbed Use Among Belgrade High School Students

“…A recent study revealed that the risk of melanoma was 41% higher in participants who had used a sunbed compared with those who had never used a sunbed, and also that the risk of melanoma was greater with earlier age at first use of sunbeds and for earlier disease onset. The participants who reported more than 10 lifetime sessions appeared some six times more likely to be diagnosed with melanoma before 30 years of age compared with never-users (7).…”

Stronger Laws Are Needed to Protect Teens From Indoor Tanning

“…Molecular evidence reveals that DNA damage is an integral part of the tanning response, 5,6 refuting the concept of the "safe tan." Epidemiologic evidence increasingly links artificial tanning to higher skin cancer risk, including melanoma risk [7][8][9][10][11] ; risk increases when tanning starts at an early age. 7,8 Melanoma incidence has risen dramatically in recent years, especially in young women.…”

“…Epidemiologic evidence increasingly links artificial tanning to higher skin cancer risk, including melanoma risk [7][8][9][10][11] ; risk increases when tanning starts at an early age. 7,8 Melanoma incidence has risen dramatically in recent years, especially in young women. 12 There will be about 76 690 new melanomas diagnosed in the US in 2013, and about 9480 people are expected to die from melanoma.…”