Prevalence Of Indoor Tanning Research Articles

Tanning bed use in Germany between 2015 and 2022: Representative data of 28,000 individuals on indoor tanning, risk awareness and reasons for use.

Tanning beds were classified as first-group carcinogens in 2009. Nonetheless, research shows that people in industrialized Western countries use tanning beds. Based on the National Cancer Aid Monitoring (NCAM) including representative data on 28,000 individuals from Germany, we quantified the prevalence as a trend from 2015 to 2022, identified determinants of tanning bed use and analysed risk awareness and reasons for use. We used NCAM data from 2015 to 2022 to analyse the trends in the prevalence of tanning bed use (n = 28,000). To determine the characteristics of tanning bed users, risk awareness and reasons, we combined data from the waves 2019 to 2022 (n = 16,000, 49.2% female, 16-65 years) in a pooled dataset to have sufficient power to detect even smaller associations. Tanning bed use decreased to 5.1% in 2022. The use of tanning beds in spas, fitness and beauty facilities increased, except during the COVID-19 pandemic, while the use in tanning salons decreased. Typical tanning bed users were female, middle-aged, occupied, higher educated, had an immigrant background and were former or current smokers. Risk awareness was the lowest among the current users. The most frequently mentioned reasons were relaxation, enhancement of attractiveness and pre-tanning. Our nationwide representative data showed that the prevalence of indoor tanning has decreased. Of concern are the lower risk awareness among current users and the shift in place of use towards facilities associated with health and wellness. To further reduce the use of tanning beds, targeted information, educational campaigns and extended legislation are considered helpful.

A Social Media–Based Public Health Campaign to Reduce Indoor Tanning in High-Risk Populations

Indoor tanning beds cause more than 450,000 new skin cancers each year, yet their use remains common, with a global indoor tanning prevalence of 10.4%. Social media provides an opportunity for cost-effective, targeted public health messaging. We sought to direct Instagram users at high risk of indoor tanning to accurate health information about the risks of indoor tanning and to reduce indoor tanning bed use. We disseminated a public health campaign on Instagram on April 6-27, 2022 with 34 video and still-image advertisements. We had 2 target audiences at high risk of indoor tanning: women aged 18-30 years in Kentucky, Nebraska, Ohio, or Tennessee interested in indoor tanning and men aged 18-45 years in California interested in indoor tanning. To evaluate the impact of the campaign, we tracked online metrics, including website visits, and conducted an interrupted time-series analysis of foot traffic data in our target states for all tanning salons documented on SafeGraph from January 1, 2018 to 3 months after the campaign. Our indoor tanning health information advertisements appeared on Instagram feeds 9.1 million times, reaching 1.06 million individuals. We received 7,004 views of our indoor tanning health information landing page (Average Time on Page of 56 seconds). We did not identify a significant impact on foot traffic data on tanning salons. We show the successful use of social media advertising to direct high-risk groups to online health information about indoor tanning. Future research quantifying tanning visits before and after indoor tanning interventions is needed to guide future public health efforts.

Prevalence of tanning equipment use among Canadians.

The objective of this study was to collect prevalence estimates of indoor tanning usage and associated injuries in Canada. The rapid response component of the 2019 Canadian Community Health Survey collected data on the use of tanning equipment in the previous 12months, including reasons for use, frequency/duration of use, precautions taken and adverse reactions or injuries. The 2019 research findings were as follows, an estimated 3.0% (95% CI: 2.5-3.4%) of Canadians reported that they had used indoor tanning equipment in the past year. Among users, 71.1% (95% CI: 63.9-78.3%) were female and females aged 18-34 were significantly more prevalent users compared to females aged 45 or older. The prevalence of indoor tanning was higher among people without a university degree; however, there were no differences in prevalence by household income or region. Most users indicated they used indoor tanning equipment within a tanning salon (75.3%: 95% CI: 69.1-81.6%) and the most common reason for usage was to develop a "protective" base tan (72.1%: 95% CI: 65.2-78.9%). Over one third (39.2%: 95% CI: 31.1-47.2%) of all users reported 10 or more sessions in the past year. The prevalence of indoor UV tanning usage is declining in Canada. Similar to results in 2014, the majority of users continue to be female, with a large number in the 18 to 34 age group.

Evaluation of Indoor Tanning Facilities in American Fitness Centers

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. The objective of this study is to evaluate availability, cost, reported risks, and adherence to legislation of IT in American fitness clubs. 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. 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). 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.

Indoor Ultraviolet Tanning Among U.S. Adolescents and Young Adults: Results From a Prospective Study of Early Onset and Persistence

PurposeThe purpose of the study was to test whether those who initiate tanning during adolescence are more likely to continue tanning in young adulthood, potentially increasing their risk for melanoma. MethodsThe study included prospective data from the Growing Up Today Study, a cohort study started in 1996 (N = 5,882). ResultsAmong men and women who ever indoor UV tanned, those who indoor UV tan by age 17 years consistently indoor tanned at least twice the prevalence as those who did not indoor UV tan by age 17 years. Indoor tanning prevalence at age 27 years was nearly 4 times as high (18.8% vs. 4.8%) among men who started indoor tanning by age 17 years than those who did not indoor tan by age 17 years. These differences persisted through age 27 years and are more pronounced in men (18.8% vs. 4.8%) than in women (30.5% vs. 13.0%). ConclusionAdolescents who indoor UV tan by age 17 years are more likely to continue to indoor tan through young adulthood than those who begin indoor UV tanning at age 18 years or older. Our findings suggest that interventions to prevent indoor UV tanning among minors may substantially reduce years of exposure to this carcinogenic behavior in young adults.

Indoor Tanning Trends Among US Adults, 2007-2018.

Objectives. To examine indoor tanning trends among US adults, and the relation to indoor tanning youth access legislation.Methods. This study analyzed the Health Information National Trends Survey (HINTS), a mailed survey, from the years 2007, 2011, 2013, 2014, 2017, and 2018 (combined n = 20 2019).Results. Indoor tanning prevalence decreased significantly over time among all US adults from 2007 (10%) to 2018 (4%; P < .001), among young adults aged 18 to 34 years (14% to 4%; P < .001), and among both women (14% to 4%; P < .001) and men (5% to 4%; P < .05). Indoor tanning significantly decreased in states that enacted youth access legislation by 2018, but did not significantly decrease for other states. Frequent indoor tanning was common in 2018; about one quarter of respondents who reported any indoor tanning did so 25 times or more in the past year.Conclusions. This study identifies several challenges in continuing to reduce indoor tanning in the United States. Youth access legislation may be effective for reducing tanning among the broader population of tanners; however, there remains a need for focus on highly frequent tanners, as well as men.

Abstract P543: Association Of Tanning Bed Use With Depression In A Preventive Medicine Cohort: The Cooper Center Longitudinal Study

Importance: The use of tanning beds continues despite evidence of increased skin cancer risk among users. In the US, the prevalence of indoor tanning ranges from 35% of adults to 59% of college students. Objective: To investigate the association between depressive symptoms and tanning bed use. Design: Cross-sectional study. Setting: A preventive medicine clinic in Dallas, Texas. Participants: Between September 2013 and June 2019, a total of 11,823 generally healthy men and women presented for preventive medical examinations. Exposure: Self-reported tanning bed use. Main Outcome and Measures: Depressive symptoms as indicated by a score of greater than or equal to 10 on the Center for Epidemiologic Studies Depression (CES-D) Scale. Results: Fifteen percent of participants had used a tanning bed prior to their examination. For men, tanning bed use was associated with an increased risk of depressive symptoms (OR: 1.86; 95% CI:1.41-2.44). For women, the association between the use of tanning beds and depressive symptoms was significant in an unadjusted model, but was no longer significant after adjustment for confounders (OR: 1.26; 95% CI:0.99-1.61). However, the odds ratio was still in the direction of increased risk. Women with a personal history of depression were more likely to tan frequently and have higher CES-D scores than women with no personal history of depression ( p = .003). Conclusions and Relevance: In a generally healthy population, depressive symptoms were associated with the use of a tanning bed. This association was more evident in those with a history of depression, although remained true for those without a history of depression. As recurrent tanning bed use is known to contribute to the diagnosis of melanoma, it is critical to help patients identify other options to treat depression as well as to educate them on the risks of routine tanning bed use.

Association between financial links to indoor tanning industry and conclusions of published studies on indoor tanning: systematic review

ObjectiveTo assess whether an association exists between financial links to the indoor tanning industry and conclusions of indoor tanning literature.DesignSystematic review.Data sourcesPubMed, Embase, and Web of Science, up to 15...

Prevalence of Indoor Tanning Among Teenagers in Norway Before and After Enforcement of Ban for Ages Under 18 Years.

Prevalence of Indoor Tanning Among Teenagers in Norway Before and After Enforcement of Ban for Ages Under 18 Years.

Indoor tanning prevalence after the International Agency for Research on Cancer statement on carcinogenicity ofartificial tanning devices: systematic review and meta-analysis.

Exposure to artificial tanning devices is carcinogenic to humans, and government regulations to restrict or ban indoor tanning appear to be increasing. We evaluated changes in the international prevalence of indoor tanning among adolescents and adults after artificial tanning devices were classified as carcinogenic by the International Agency for Research on Cancer (IARC) in 2009. Systematic searches in PubMed and Web of Science databases were undertaken. Overall, 43 studies reporting 'ever' or 'past-year' indoor tanning exposure after 2009 were identified. We used metaregression analysis to evaluate the prevalence of indoor tanning over time. Random effects meta-analysis was used to summarize the prevalence of indoor tanning in adolescents and adults according to sex, region and presence of age prohibitions. Global prevalence of indoor tanning in adolescents for 2013-2018 was 6·5% [95% confidence interval (CI) 3·3-10·6], 70% lower than the 22·0% (95% CI 17·2-26·8) prevalence for 2007-2012. Among adults, the prevalence was 10·4% (95% CI 5·7-16·3) for 2013-2018, a decrease of 35% from 18·2% for 2007-2012. Since 2009, the overall past-year prevalence among adolescents was 6·7% (95% CI 4·4-9·6) and 12·5% (95% CI 9·5-15·6) among adults. The prevalence of tanning indoors in the past year was similar in North America (adults, 12·5%; adolescents, 7·6%) and Europe (adults, 11·1%; adolescents, 5·1%). In 2009, three countries had regulations restricting indoor tanning, compared with 26 countries today. Prevalence of indoor tanning has declined substantially and significantly in adolescents and adults since the 2009 IARC statement, reflecting the rise in regulations that limit this source of unnecessary exposure to carcinogenic ultraviolet radiation. What is already known about this topic? Indoor tanning is associated with an increased risk of melanoma. A meta-analysis of worldwide indoor tanning prevalence for 1986-2012 found a past-year prevalence of 18% in adolescents and 14% in adults, with higher prevalences during the period 2007-2012. Policies to regulate indoor tanning began to be implemented across the globe in 2009. Only one study carried out in the U.S.A. has evaluated the efficacy of such policies in reducing indoor tanning prevalence. What does this study add? For the period 2013-2018, we found indoor tanning prevalences of 6·7% in adolescents and 11·9% in adults. This implies a reduction in indoor tanning use of 70% in adolescents and 35% in adults during the last 10 years. Our study encourages policy makers to strengthen indoor tanning regulations that reduce sunbed use among the general population in order to produce maximum public health benefit.

Prevalence of Indoor Tanning Among U.S. High School Students from 2009 to 2017.

Indoor tanning exposes users to high levels of ultraviolet radiation, increasing skin cancer risk. The risk is greatest for those who begin indoor tanning at a young age. The objective of this study was to assess changes in indoor tanning prevalence over time among U.S. high school students, by sex, age, and race/ethnicity. We used cross-sectional data from the 2009, 2011, 2013, 2015, and 2017 national Youth Risk Behavior Survey to examine changes in indoor tanning prevalence from 2009 to 2017 and from 2015 to 2017. From 2009 to 2017 indoor tanning declined overall (15.6 to 5.6%; p < 0.001), across all age groups, and among white (37.4 to 10.1%; p < 0.001) and Hispanic (10.5 to 3.0%; p < 0.001) female students, and white (7.0 to 2.8%; p < 0.001) and Hispanic (5.8 to 3.4%; p < 0.001) male students. From 2015 to 2017, indoor tanning declined overall (7.3 to 5.6%; p = 0.04) and among white (15.2 to 10.1%; p = 0.03) and Hispanic (5.8 to 3.0%; p = 0.02) female students, and 16-year-old students (7.2 to 4.7%; p = 0.03). Indoor tanning has continued to decrease, particularly among white and Hispanic female students, dropping well below the Healthy People 2020 target for adolescents. However, continued efforts are needed to further reduce and sustain reductions in adolescent indoor tanning and address remaining research gaps.

Indoor tanning and skin cancer in Canada: A meta-analysis and attributable burden estimation

BackgroundConsistent epidemiologic and experimental studies have demonstrated that UV-emitting tanning devices cause melanoma and non-melanoma skin cancer. The purpose of this study was to estimate the relative risk of skin cancer associated with the use of indoor tanning devices relevant to Canada, to estimate the proportion and number of skin cancers in Canada in 2015 that were attributable to indoor tanning, and to explore differences by age and sex. MethodsSkin cancer cases attributable to the use of an indoor tanning devices were estimated using Levin’s population attributable risk (PAR) formula. Relative risks for skin cancer subtypes that were relevant to Canada were estimated through meta-analyses and prevalence of indoor tanning was estimated from the 2006 National Sun Survey. Age- and sex-specific melanoma data for 2015 were obtained from the Canadian Cancer Registry, while estimated NMSC incidence data were obtained from the 2015 Canadian Cancer Statistics report. ResultsEver use of indoor tanning devices was associated with relative risks of 1.38 (95% CI 1.22–1.58) for melanoma, 1.39 (1.10–1.76) for basal cell carcinoma (BCC), and 1.49 (1.23–1.80) for squamous cell carcinoma (SCC). Overall, 7.0% of melanomas, 5.2% of BCCs, and 7.5% of SCCs in 2015 were attributable to ever of indoor tanning devices. PARs were higher for women and decreased with age. ConclusionIndoor tanning contributes to a considerable burden of skin cancer in Canada. Strategies aimed at reducing use should be increased and a total ban or restrictions on use and UV-intensity should be considered by health regulators.

Trends in Melanoma Incidence Rates in Eight Susceptible Populations through 2015

Trends in Melanoma Incidence Rates in Eight Susceptible Populations through 2015

State Indoor Tanning Laws and Prevalence of Indoor Tanning Among US High School Students, 2009–2015

To examine the association between state indoor tanning laws and indoor tanning behavior using nationally representative samples of US high school students younger than 18 years. We combined data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Surveys (n = 41 313) to analyze the association between 2 types of state indoor tanning laws (age restriction and parental permission) and the prevalence of indoor tanning during the 12 months before the survey, adjusting for age, race/ethnicity, and survey year, and stratified by gender. Age restriction laws were associated with a 47% (P < .001) lower indoor tanning prevalence among female high school students. Parental permission laws were not found to be associated with indoor tanning prevalence among either female or male high school students. Age restriction laws could contribute to less indoor tanning, particularly among female high school students. Such reductions may reduce the health and economic burden of skin cancer.

Effect of Legislation on Indoor Tanning Prevalence in Alabama.

To examine changes in indoor tanning prevalence among Alabama high school students the year before and after its 2014 legal restrictions compared with Florida, which had more lenient legislation. We analyzed the Alabama and Florida 2015 Youth Risk Behavior Survey (n = 14 389; population = 1 864 241) by gender, age, year (2013, 2015), state (Alabama, Florida), and year-by-state interactions. Prevalence of indoor tanning was higher among Alabama youths, but the difference did not significantly change after the law was passed in Alabama (between-state change differences ranged from a 3.3% increase among 14-year-old Alabama girls to a 9.7% decrease among 14-year-old Alabama boys). We found no significant changes in indoor tanning among adolescents since the enactment of Alabama's tanning restrictions in 2014. More oversight and monitoring are needed to ensure that indoor tanning facilities are compliant with emerging laws.

A Cross-Sectional Study of Indoor Tanning in Fitness Centres.

Ultraviolet (UV) radiation is a human carcinogen and is associated with the development of skin cancer. The promotion of indoor tanning (IT) at fitness centres is of particular concern as it reinforces the idea that a tan is associated with health and fitness. The purpose of this study was to investigate the prevalence of IT in fitness centres, with an emphasis on determining the financial costs, adherence to regulations, and safety precautions. Ten cities, representing 9 different Canadian provinces, were chosen for the study. From each province, a minimum of 20 and a maximum of 30 fitness centres were randomly selected from the Yellow Pages website. Each fitness centre was contacted by the principal investigator and inquiries were made from a consumer's perspective. Of the 203 gyms surveyed, 43% (88/203) offered tanning facilities. Of these, 10.23% (9/88) were found to be noncompliant with the provincial IT regulations for age and/or time between tanning sessions. Despite the known risks of IT, not all fitness centres are compliant with provincial legislations regarding IT, and some continue to promote tanning access to minors.

Prevalence of Indoor Tanning and Association With Sunburn Among Youth in the United States

Indoor tanning and sunburns, particularly during adolescence and young adulthood, increase the risk of developing skin cancer. To examine the trends in the prevalence of indoor tanning and the association between indoor tanning and sunburn among US high school students. This study pooled and examined cross-sectional data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Survey. During 2009, 2011, 2013, and 2015, the overall response rates were 71%, 71%, 68%, and 60%, respectively, and unweighted sample sizes were 16 410, 15 425, 13 538, and 15 624, respectively. It included nationally representative samples of US high school students. Data were collected during the spring semester (January to June) in each survey cycle beginning February 9, 2009, through June 18, 2015. Prevalence of indoor tanning in the past year from 2009 to 2015 and its association with sunburn in 2015. Among high school students in the United States, the prevalence of indoor tanning decreased from 15.6% (95% CI, 13.7%-17.6%) in 2009 to 7.3% (95% CI, 6.0%-8.9%) in 2015. Decreases in indoor tanning were found among male (from 6.7% in 2009 to 4.0% in 2015) and female (from 25.4 % in 2009 to 10.6 % in 2015) students overall, non-Hispanic white (from 21.1 % in 2009 to 9.4% in 2015) and Hispanic (from 8.2% in 2009 to 4.7% in 2015) students overall, and all age groups. Among non-Hispanic white female students, the prevalence decreased from 37.4% (95% CI, 33.6%-41.4%) in 2009 to 15.2% (95% CI, 11.7%-19.5%) in 2015. In 2015, indoor tanning was associated with sunburn in the adjusted model: 82.3% (95% CI, 77.9%-86.0%) of indoor tanners had at least 1 sunburn during the preceding year compared with 53.7% (95% CI, 48.9%-58.4%) of those who did not engage in indoor tanning (P < .001). Despite declines in the prevalence of indoor tanning from 2009 to 2015 among high school students nationwide, indoor tanning remains commonplace among certain subgroups, especially non-Hispanic white female students. Three-quarters of those who engaged in indoor tanning had experienced at least 1 sunburn. Efforts by the public health and medical communities are needed to further reduce the prevalence of indoor tanning and sunburn and thus prevent future cases of skin cancer.

Health behaviours associated with indoor tanning based on the 2012/13 Manitoba Youth Health Survey.

Although indoor tanning causes cancer, it remains relatively common among adolescents. Little is known about indoor tanning prevalence and habits in Canada, and even less about associated behaviours. This study explores the prevalence of adolescent indoor tanning in Manitoba and its association with other demographic characteristics and health behaviours. We conducted secondary analyses of the 2012/13 Manitoba Youth Health Survey data collected from Grade 7 to 12 students (n = 64 174) and examined associations between indoor tanning (whether participants had ever used artificial tanning equipment) and 25 variables. Variables with statistically significant associations to indoor tanning were tested for collinearity and grouped based on strong associations. For each group of highly associated variables, the variable with the greatest effect upon indoor tanning was placed into the final logistic regression model. Separate analyses were conducted for males and females to better understand sex-based differences, and analyses were adjusted for age. Overall, 4% of male and 9% of female students reported indoor tanning, and prevalence increased with age. Relationships between indoor tanning and other variables were similar for male and female students. Binary logistic regression models indicated that several variables significantly predicted indoor tanning, including having part-time work, being physically active, engaging in various risk behaviours such as driving after drinking for males and unplanned sex after alcohol/drugs for females, experiencing someone say something bad about one's body shape/size/appearance, identifying as trans or with another gender, consuming creatine/other supplements and, for females only, never/rarely using sun protection. Indoor tanning among adolescents was associated with age, part-time work, physical activity and many consumption behaviours and lifestyle risk factors. Though legislation prohibiting adolescent indoor tanning is critical, health promotion to discourage indoor tanning may be most beneficial if it also addresses these associated factors.

Abstract IA09: What's new in melanoma etiology?

Abstract Melanoma (CM) incidence continues to increase in the US, Europe, and Australia. A concern has been raised whether this is a true increase of CM or a major increase in over diagnosis of CM. Data cited in support of over diagnosis are that mortality rates have not increased proportionately. Another explanation of disproportionate incidence and mortality is that as CM has become more common and both care providers and the general population are more aware of CM, lesions are identified and removed much earlier, leading to better long-term prognosis. In the US, the 5-year relative survival has increased from 81.8% in 1975 to 92.8% in 2006. The distribution of CM differs between men and women; recent data in the U.S. have shown a distinct increase in CM on the trunk of young women, consistent with tanning (Bradford PT et al., CEBP 2010; 19:2410-6). In 2011, there were 960,231 individuals with CM in the US who are at 8.8-fold increased risk of a second primary CM. The major risk factors for CM include genetic susceptibility (covered in detail by Nick Hayward in this session) and ultraviolet exposure. The major high risk susceptibility genes, CDKN2A and CDK4, were identified in the mid-nineties; mutations in either confer similar risks for CM and similar clinical features. More recently, mutations in POT1 were identified in melanoma-prone families using exome sequencing (Robles-Espinoza CD et al., Nat Genet 2014; 46:478-81; Shi J, et al., Nat Genet 2014; 46:482-6). Other rare high risk susceptibility genes will likely be identified. Genome-wide association studies have identified a number of common variants associated with CM; the causal variants marked by the association signals are in large part still being identified. Nevi, particularly dysplastic nevi, are major host susceptibility factors, but nevus genes have been quite challenging to identify. Using a candidate gene approach, Liang et al. identified variants in CDK6 and XRCC1 that were associated with dysplastic nevi, but not CM (J Invest Derm 2014;134:481-7). Ultraviolet radiation exposure is causal for CM, whether from the sun or artificial lights. Tanning is a complex behavior, and it is difficult to separate the risks associated with outdoor and indoor tanning since most who tan use both sources. Wehner et al. conducted a systematic review and metaanalysis of the prevalence of indoor tanning and found that 35.7% (95% CI 27.5%-44.0%) of adults, 55.0% (33.0%-77.1%) of university students and 19.3% (14.7%-24.0%) of adolescents had ever used indoor tanning (JAMA Dermatol 2014;150:390-400). The prevalences varied also by geographic area and sex. Due to the high exposure rates, particularly in adolescents, parts of Europe, Australia, and North America have passed legislation limiting access by adolescents to indoor tanning. There is also a growing body of evidence that UV exposure may be addictive (Heckman CJ et al., Am J Health Promo 2014;28:168-174). The role of screening for CM has been controversial. In 2009, the USPSTF guidelines did not recommend population-based screening for CM. This year, they are reconsidering the issue, in part because of a public health effort in Germany, where screening for skin cancer was made available for adults over 20 (Katalinic A et al., Cancer, 2012; 118:5395-402). In an observational study, melanoma mortality declined by 47% for men and 49% for women in the screened population. Screening may yield higher benefits in recognized at risk groups (Moloney FJ et al. JAMA Dermatol 2014.514). A number of melanoma risk assessment tools could be useful in prioritizing screening, but have not been fully validated (Vuong K et al; JAMA Dermatol 2014;150:434-444). Citation Format: Margaret A. Tucker. What's new in melanoma etiology? [abstract]. In: Proceedings of the AACR Special Conference on Advances in Melanoma: From Biology to Therapy; Sep 20-23, 2014; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(14 Suppl):Abstract nr IA09.

Update on indoor tanning legislation in the United States

The incidence of melanoma has been increasing over the past several decades, with notable increases in the pediatric and adolescent population. Indoor tanning has been proven carcinogenic and is associated with an increased risk of melanoma, especially when used at a young age. The incidence and frequency of usage of indoor tanning in the United States is high, particularly among adolescents, with roughly 20% reporting using a tanning bed at least once. The Food and Drug Administration recently made changes to its regulation of indoor tanning devices, reclassifying them as class II devices necessitating stricter premarket review, and strengthened its warnings for these devices; however, federal regulation of indoor tanning is still limited and most regulation of indoor tanning in minors is done on a state-by-state basis. Three types of legislation exist: (1) absolute ban on minor use of indoor tanning devices, (2) age restriction of minor usage of indoor tanning devices other than age 18 years, and (3) requirement of parental consent. These regulations are inconsistent, and enforcement efforts are often limited. In this contribution, we provide an update on the prevalence of indoor tanning, the risks associated with indoor tanning, and the current federal and state legislation and enforcement efforts in the United States with regard to indoor tanning. Although efforts are being made to ban all use of indoor tanning devices by minors, there is still more work to be done before this becomes a reality in the United States.