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Cited by 107Nonmelanoma Skin Cancer StudiesSkin Protection and AgingHead and Neck Cancer Studies

Indoor tanning and risk of early-onset basal cell carcinoma

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Ferrucci, Leah M., Cartmel, Brenda, Molinaro, Annette M., Leffell, David J., Bale, Allen E., Mayne, Susan T.·2012·Journal of the American Academy of Dermatology
DOI 10.1016/j.jaad.2011.11.940PMC PMC3307842
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Abstract

Background Despite an increase in incidence of basal cell carcinoma (BCC) among young people and the ubiquity of indoor tanning in this population, few epidemiologic studies have investigated this exposure-disease relationship. Objective We sought to evaluate the association between indoor tanning and early-onset BCC. Methods Patients with BCC (n = 376) and control subjects with minor benign skin conditions (n = 390) who were younger than 40 years of age were identified through Yale Dermatopathology. Participants provided information on ever indoor tanning, age of initiation, frequency, duration, burns while tanning, and type of tanning device during an in-person interview. We calculated odds ratios (OR) and 95% confidence intervals (CI) using multivariate logistic regression with never indoor tanners as the referent group. Results Ever indoor tanning was associated with a 69% increased risk of early-onset BCC (95% CI 1.15-2.48). This association was stronger among females (OR 2.14, 95% CI 1.31-3.47), for multiple BCCs (OR 2.16, 95% CI 1.26-3.70), and for BCCs on the trunk and extremities (OR 2.81, 95% CI 1.57-5.02). Risk increased dose dependently with years using regular indoor tanning devices (P trend = .003), number of overall burns (P trend < .001), and burns to biopsy site (P trend < .001) from indoor tanning. Approximately one quarter (27%) of early-onset BCCs (or 43% among women) could be prevented if individuals never tanned indoors. Limitations Potential recall bias of indoor tanning by patients and generalizability of the control population suggest replication in other studies is warranted. Conclusions Indoor tanning was a strong risk factor for early-onset BCC, particularly among females. Indoor tanning should continue to be targeted by both policy-based and behavioral interventions, as the impact on BCC-associated morbidity may be substantial.

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  • Increased exposure to sunlight or use of tanning beds can result in much earlier diagnosis of skin cancers, early in the third decade of life, in normal individuals.

    “Although increased exposure to sunlight or use of tanning beds can result in much earlier diagnosis of skin cancers (early in the third decade of life) in normal individuals (43, 44), this age of onset is still a decade beyond the average lifespan of a CS patient.”

    From Why Cockayne syndrome patients do not get cancer despite their DNA repair deficiency (2016) · cites this paper as [44]

    The Results (page unavailable) associate indoor tanning with increased risk of early-onset basal cell carcinoma in people under 40. They do not establish diagnosis early in the third decade of life: the median age at skin biopsy was approximately 36. The paper discusses sunlight exposure as a risk factor but does not show that increased sunlight exposure causes diagnosis at the claimed age. (LLM, conf=0.88)

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  1. [6]Karagas MR Greenberg ER Spencer SK Stukel TA Mott LA Increase in incidence rates of basal cell and squamous cell skin cancer in New Hampshire, USA. New Hampshire Skin Cancer Study Group. Int J Cancer 1999 81 555 9 10225444

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Authors
Ferrucci, L. M., Cartmel, B., Molinaro, A. M., Leffell, D. J., Bale, A. E., & Mayne, S. T.
Affiliations
  • Yale University (US)
  • Yale Cancer Center (US)
Corresponding author
Mayne, Susan T.
ORCID
Venue
Journal of the American Academy of Dermatology
Publisher
Elsevier BV
Published
2012-10
Volume
67
Issue
4
Pages
552-562
ISSN
0190-9622 (ISSN-L)
DOI
10.1016/j.jaad.2011.11.940
PMC
PMC3307842
OpenAlex
W1982009692
Cited by
107
References
39
Citations by year
2026: 4 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 8 · 2020: 9 · 2019: 3 · 2018: 6 · 2017: 15 · 2016: 8 · 2015: 11 · 2014: 12 · 2013: 8 · 2012: 7
FWCI
6.13
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American Academy of Dermatology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute (F32CA144335, R01CA163687, P50CA121974)
  • National Center for Research Resources (UL1RR024139)
Topics
  • Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
  • Health Sciences › Medicine › Dermatology › Skin Protection and Aging
  • Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
Keywords
indoor tanning, basal cell carcinoma, tanning beds, skin cancer risk factors, dose-response relationship, burns, sex differences, multiple basal cell carcinoma, skin cancer prevention
MeSH terms
Adult, Basal Cell Carcinoma, Female, Humans, Male, Risk Factors, Skin Neoplasms, Skin Pigmentation, Sunburn, Ultraviolet Rays, Case-Control Studies, Age of Onset, Age Distribution, Sex Distribution, Genetic Predisposition to Disease, Receptor, Melanocortin, Type 1, Sunbathing

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