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Reviewed by Louise Chang, MD
Oct. 2, 2012 -- Indoor tanning beds may raise the risk of non-melanoma skin cancers, especially among people who start tanning before they turn 25, a new study suggests.
Previous studies have linked indoor tanning with melanoma, the deadliest form of skin cancer. But the new study extends these findings to the more common but less serious skin cancers, basal cell carcinoma and squamous cell carcinoma.
Specifically, people who used tanning beds were 67% more likely to develop squamous cell carcinoma and 29% more likely to develop basal cell carcinoma than people who never used them. This risk was highest among people who started to tan before their 25th birthday.
Researchers reviewed 12 studies in medical literature published since 1985. They estimate that indoor tanning is responsible for more than 170,000 new cases of non-melanoma skin cancers in the United States each year -- and many more worldwide.
"Although these types of skin cancers are not deadly, they are very common and expensive to treat," says researcher Eleni Linos, MD, DrPH. She is an assistant professor of dermatology at the University of California, San Francisco. The study is published online in the journal BMJ.
So with all the bad press, why are people still going tanning? "People go to tanning beds because they like the feeling of the beds and like to look tan, and don't understand the risks involved," she says.
Is It Time to Ban the Tan?
It's time to amp up prevention messages and measures in the U.S., Linos says. "Ideally, we'd like people to hear the message and make their own choices but at some point, especially when it comes to children and minors, regulation becomes important."
As it stands, the World Health Organization states that ultraviolet tanning devices cause cancer. The International Agency for Research on Cancer considers indoor tanning a Class 1 carcinogen.
Ban-the-tan efforts that restrict tanning by minors are under way in many U.S. states and cities. Australia and Europe have banned tanning beds for children and teenagers, and Brazil has banned tanning beds for everyone.
In the U.S., "the next step is to figure out what measures are most effective at reducing indoor tanning use," Linos says. "Placing restrictions on indoor smoking, taxes on cigarettes, and changing the perception of smokers as cool all helped reduce smoking rates. We need to figure out which of those methods will work for indoor tanning."
The time is now, agrees Joshua Zeichner, MD, He is a dermatologist at the Mount Sinai Medical Center in New York City. "Any measures taken to discourage indoor tanning will help prevent cancers in the long run and lower associated health care costs," he says.
The message is clear: "Especially for young people, who want to look tan for the prom or a special event, stay away from tanning booths."
Craig Devoe, MD, is in favor of a heftier tanning tax. He is an oncologist at the Center for Melanoma and Rare Skin Cancers at the North Shore-LIJ Health System in Great Neck, N.Y. There is a 10% tax on indoor tanning in the U.S.
"These cancers may not be lethal, but they can be disfiguring," he says.
What's more, the risks of indoor tanning should be covered in health education classes, much like smoking. "To get tan, the ultraviolet rays must cause damage to your DNA. This is how you get tan," he says. "There is a lot of misinformation by tanning salons about so-called safe tanning and the health effects of vitamin D."
Tanning Industry Responds
John Overstreet is the executive director of the Indoor Tanning Association, an industry trade group in Washington, D.C. He defends some of the benefits of indoor tanning, especially as it pertains to vitamin D exposure.
"It seems the risks continue to grab the headlines in the media, while the benefits remain unnoticed and unpromoted," he says. "This paper is another example of continuing efforts to focus on risks."
Basal and squamous cell skin cancers are rarely fatal and easily treated, he says.
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SOURCES:Eleni Linos, MD, DrPH, assistant professor of dermatology, University of California, San Francisco.John Overstreet, executive director, Indoor Tanning Association, Washington, D.C.Craig Devoe, MD, oncologist, the Center for Melanoma and Rare Skin Cancers, North Shore-Long Island Jewish Health System, Great Neck, N.Y.Joshua Zeichner, MD, dermatologist, Mount Sinai Medical Center, New York City.Wehner, M. BMJ, 2012, study received ahead of print.Olsen, C. BMJ, 2012, study received ahead of print.Williams, S. BMJ, 2012, study received ahead of print.
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