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Indoor tanning before age 35 increases melanoma risk by up to 75%, and melanoma risk increases by 1.8% with each additional tanning session per year. Use before age 25 increases nonmelanoma skin cancer risk by up to 102%. Melanoma incidence is increasing, especially among young, non-Hispanic white women. Indoor tanning may be a causative factor, but prevalence data are limited.
Investigators used the 2011 Youth Risk Behavior Survey (YRBS) of high school students and the 2010 National Health Interview Survey (NHIS) of adults aged 18 to 34 years to study indoor tanning prevalence among non-Hispanic white women. Both surveys are conducted by the CDC. Indoor tanning was defined as use of a tanning device at least once in the prior 12-month period, and 10 or more times in that period constituted “frequent” use.
Of 2527 non-Hispanic white female high school student respondents (grades 9-11; age range, 14-18 years) to the YRBS, 29% had engaged in indoor tanning; 17% of all responders and 57% of ever-tanners tanned frequently. The prevalence and frequency of indoor tanning increased with age. Of 1857 non-Hispanic white female respondents to the NHIS (age range, 18-34 years), 25% engaged in indoor tanning, 15% frequently in the previous year. In these respondents, prevalence and frequency of indoor tanning decreased with age. In both surveys, the prevalence was highest in the South and Midwest.
Guy GP et al. Indoor tanning among young non-Hispanic white females. JAMA Intern Med 2013 Aug 19; [e-pub ahead of print]. (http://dx.doi.org/10.1001/jamainternmed.2013.10013)
Comment
These data show that indoor tanning is rampant among non-Hispanic white women, especially older high school girls. Although WHO has classified ultraviolet radiation as a class I carcinogen, the tanning industry is a thriving, largely unregulated $2 billion industry. In my office, an American Academy of Dermatology poster describing the dangers of indoor tanning has triggered many comments from parents and teens, with many saying they thought tanning was safe. Appearance-focused interventions and education are helpful for teenagers, but eliminating deceptive advertising claims and preventing access by minors are also crucial.