According to a study recently published in the Journal of the American Medical Association (JAMA) Dermatology, individuals who frequently tan indoors are more likely to sunburn, and avoid sun protection and skin cancer screening, and therefore have a risk for skin cancer beyond that attributable to indoor tanning alone.
Previous studies have suggested that indoor tanning is linked to an elevated risk of melanoma, with greater risk among people who begin indoor tanning before the age of 35 years old. People who tan indoors are more likely to have an increased exposure to the sun, which may extend their risk for skin cancer beyond the risk that is related to indoor tanning alone. Likewise, indoor tanning is associated with a lower likelihood of engaging in behaviours related to skin cancer prevention. However, research examining the link between frequency of indoor tanning and primary and secondary skin cancer prevention behaviours are limited. Additionally, very few studies examining the association between indoor tanning and sun protection focus on the young adult population, even though indoor tanning is highly common in this age group. Thus, a group of researchers conducted a study to investigate the link between frequency of indoor tanning and primary and secondary skin cancer prevention behaviours, and to look at whether this link varies by sex or age.
The researchers conducted this study by using self-reported survey data from the cross-sectional population-based study of US 2015 National Health Interview Survey (NHIS). They examined a population of 10, 262 individuals who were non-Hispanic white adults (49% female, 51% male), who had no history of skin cancer, and who were between the ages of 18 and 60 years old. Frequency of indoor tanning was defined as the number of times that a participant had used a sunbed, sunlamp, or tanning booth (excluding spray-on tans) in the past year. Responses were classified as none (0 times), moderate (1 to 9 times), and frequent (more than 10 times) indoor tanning. Participants were also asked questions related to how often they stay in the shade, use sunscreen, wear a hat that shades the neck, face and ears, wear long pants, and wear a long-sleeved shirt; responses were classified as always, most of the time, sometimes, rarely, or never. ‘Multiple sunburns’ was defined as having a minimum of 2 sunburns within the past year.
The findings, published in JAMA Dermatology, showed that individuals who tanned indoors frequently (more than 10 times each year) were more likely to report practicing poor sun-protection on a warm, sunny day and were more probable to report multiple (minimum of 2) sunburns in the past 12 months, in comparison to individuals who did not engage in indoor tanning in the past year. Among participants between the ages of 18 and 34 years old — compared to those who did not tan indoors — people who tanned indoors frequently were more likely to disclose never/rare use of shade and protective clothing. Among women between 18 and 60 years old, in contrast to those who did not tan indoors, those who were frequent indoor tanners were more likely to rarely/never use protective clothing, shade and sunscreen on a warm sunny day, in addition to being more likely to report multiple sunburns within the past 12 months. Moreover, compared to participants who did not tan indoors, those who engaged in indoor tanning were not notably more likely to have undergone a full-body skin examination, irrespective of age or sex.
The overall findings suggest that people who tan indoors often display a simultaneous inclination to avoid sunscreen protection, to sunburn, and to avoid skin cancer screening. Individuals who tan indoors frequently already have an alarming risk for the development of skin cancer, but still continue to increase exposure to the sun and practice poor sunscreen protection, thereby elevating their risk for skin cancer beyond that related to engaging in indoor tanning alone. Likewise, this group of people is not considerably more likely to undergo skin cancer screening. The findings show that many people who tan indoors may not recognize the longstanding skin cancer risks related to increased exposure to harmful UV radiation. Therefore, these results underline the significance of not just stressing avoidance of indoor tanning via physician communication and public health messages, but also repeating the importance and need for regular skin cancer screening and sun protection among individuals who indoor tan. Taking an active part in skin cancer screening and sun protection among populations that are at high risk, such as indoor tanners, could possibly decrease the mortality and morbidity related to skin cancer.
Written By: Nigar Celep, BASc