Abstract
Simple SummaryMotivated 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.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.
Highlights
Skin cancer, including melanoma and non-melanoma skin cancer (NMSC), is the fifth most commonly occurring cancer, with over 1 million diagnoses worldwide and incidence rates continuing to increase rapidly [1,2]
We found a significant association for tanning device use with NMSC in the studies recruited after 2000 (RR = 1.39, 95% confidence intervals (CIs) 1.17–1.66) (Table 2 and Figures S8 and S9)
This study found that first exposure at an early age to indoor tanning was associated with 1.47-fold higher risk for melanoma
Summary
Skin cancer, including melanoma and non-melanoma skin cancer (NMSC), is the fifth most commonly occurring cancer, with over 1 million diagnoses worldwide and incidence rates continuing to increase rapidly [1,2]. The sharpest increase in risk is observed in people younger than 40 years of age [3,4,5]. These cases of early-onset skin cancer may represent gene–environment interaction, among individuals with genetic susceptibility [6,7]. Environmental factors may play an important role in primary prevention for skin cancer in younger adults. Exposure to ultraviolet (UV) radiation is a major environmental factor for melanoma and NMSC. Almost 90% of all melanomas, 85% of squamous cell carcinoma (SCC), and 82% of basal cell carcinoma (BCC) were attributable to excess
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