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Indoor Tanning and Risk of Melanoma: A Case-Control Study in a Highly Exposed Population
Open accessAbstract
Background: Indoor tanning has been only weakly associated with melanoma risk; most reports were unable to adjust for sun exposure, confirm a dose-response, or examine specific tanning devices. A population-based case-control study was conducted to address these limitations. Methods: Cases of invasive cutaneous melanoma, diagnosed in Minnesota between 2004 and 2007 at ages 25 to 59, were ascertained from a statewide cancer registry; age-matched and gender-matched controls were randomly selected from state driver's license lists. Self-administered questionnaires and telephone interviews included information on ever use of indoor tanning, types of device used, initiation age, period of use, dose, duration, and indoor tanning–related burns. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for known melanoma risk factors. Results: Among 1,167 cases and 1,101 controls, 62.9% of cases and 51.1% of controls had tanned indoors (adjusted OR 1.74; 95% CI, 1.42-2.14). Melanoma risk was pronounced among users of UVB-enhanced (adjusted OR, 2.86; 95% CI, 2.03-4.03) and primarily UVA-emitting devices (adjusted OR, 4.44; 95% CI, 2.45-8.02). Risk increased with use: years (P < 0.006), hours (P < 0.0001), or sessions (P = 0.0002). ORs were elevated within each initiation age category; among indoor tanners, years used was more relevant for melanoma development. Conclusions: In a highly exposed population, frequent indoor tanning increased melanoma risk, regardless of age when indoor tanning began. Elevated risks were observed across devices. Impact: This study overcomes some of the limitations of earlier reports and provides strong support for the recent declaration by the IARC that tanning devices are carcinogenic in humans. Cancer Epidemiol Biomarkers Prev; 19(6); 1557–68. ©2010 AACR.
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“The lower-energy UVA (315-400 nm), which constitutes ~95% of the ultraviolet energy that penetrates the atmosphere, also induces melanoma in mice and in humans who use tanning beds, but it is inefficient at making the cytosine-containing CPD that cause C→T mutations (12, 13).”
From Chemiexcitation of melanin derivatives induces DNA photoproducts long after UV exposure (2015) · cites this paper as [12]
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“Some studies have found a similar dose-dependent effect of indoor tanning independent of age166, although another found that tanning increased risk for young women167.”
From Mechanisms and prevention of UV‐induced melanoma (2018) · cites this paper as [166]
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“Minnesota has had a substantial increase in melanoma rates, and frequent indoor tanning has been associated with this increase.(10) Epidemiologic studies in Olmsted County, MN, found that between 1970 and 2009 the melanoma incidence increased 8-fold inwomen and 4-fold inmen 18 to 39 years of age(11) and 24-fold in wom…”
BackgroundMethodInfluentialContemporary Peculiarities of Cutaneous Melanomas in Minsk
Барабанов, А. Л., & Зейналлы, Н. А. (2020) · Дерматовенерология Косметология · doi:10.34883/pi.2020.6.3.001 · Cited by 1
Younger age at melanoma diagnosis: a survey study of indoor tanning use
Mahoney, M. E., Wu, A., Li, H., Guo, D., Burbidge, T., Batuyong, E., Poleman, S., Ernst, M., & Cheng, T. Q. (2026) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2026.03.039 · Cited by 1
Rare Tumors of the Skin and Subcutaneous Tissues
Pappo, A. S., Eigentler, T., Garbe, C., Collini, P., Ferrari, A., & Rössler, J. K. (2011) · Pediatric oncology · doi:10.1007/978-3-642-04197-6_43 · Cited by 1
Carolyn, J., Darlow, S. D., Munshi, T., & Perlis, C. (2013) · InTech eBooks · doi:10.5772/55243 · Cited by 1
Exploring the Unique Characteristics of Cancer in Adolescents and Young Adults in Tennessee
Quinn, M. (2012) · Digital Commons - East Tennessee State University (East Tennessee State University) · Cited by 1
Lane, S. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/bt1w-5a39 · Cited by 1
Has too much blame been placed on tanning beds for the rise in melanoma diagnosis?
Rivera, A., Han, J., & Qureshi, A. A. (2013) · Expert Review of Dermatology · doi:10.1586/edm.13.10 · Cited by 1
Panning, C., Smith, A., Spohn, O., & van Wesenbeeck, L. (2016) · Environmental Health Review · doi:10.5864/d2016-005 · Cited by 1
“Information presented by tanning facilities needs to be monitored and regulated, especially regarding false health benefit claims (Lazovich et al., 2010; Zhang et al., 2012; Guy et al., 2014).”
BackgroundInfluentialDetermining the effectiveness of sunscreens
Kennon, J. T., Fong, B. N., & Grippo, A. A. (2016) · Science Activities · doi:10.1080/00368121.2016.1188053 · Cited by 1
“increased in years, hours or sessions of indoor tanning sessions (Lazovich et al. 2010).”
BackgroundMultiple junctional nevi on the buttocks: An indicator of tanning bed use
Little, C., & Lloyd, J. R. (2017) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2016.11.004 · Cited by 1
Taddeo, D., & Stanwick, R. S. (2012) · Paediatrics & Child Health · doi:10.1093/pch/17.2.90 · Cited by 1
Examining Dermatologist Use and Opinions of Ultraviolet Radiation for Cosmetic and Medical Purposes.
Sampson, B. P., Secrest, A. M., Hansen, C. B., & Geller, A. C. (2018) · PubMed Central · Cited by 1
Introduction to Head and Neck Melanoma
Faraj, Y., & Beltrani, V. P. (2022) · Oral and Maxillofacial Surgery Clinics of North America · doi:10.1016/j.coms.2021.11.007 · Cited by 1
Berwick, M. (2011) · Springer eBooks · doi:10.1007/978-3-7091-0371-5_3 · Cited by 1
Self-citationMelanoma Cell Signalling: Looking Beyond RAS-RAF-MEK
Muthusamy, V., & Terrence, J. (2011) · InTech eBooks · doi:10.5772/26725 · Cited by 1
“However, the type (UVA versus UVB) and duration of UV radiation (intermittent versus chronic and childhood sun exposure) necessary for melanoma initiation remains ambiguous (Algazi et al., 2010; Besaratinia and Pfeifer, 2008; Lazovich et al., 2010; Walker, 2008).”
Xie, R., Han, B., Li, L., Wang, Q., Zhu, L., & Dai, Q. (2011) · International Conference on Bioinformatics and Biomedical Engineering · doi:10.1109/icbbe.2011.5780041 · Cited by 1
“However, only less than 70% [2] patient are response to the chemotherapy, and the predict the prognosis of chemotherapy response is becoming paramountly important for personalized medicine [ 3 ].”
BackgroundBerwick, M. (2017) · Springer eBooks · doi:10.1007/978-3-319-41319-8_3 · Cited by 1
Self-citationLluria-Prevatt, M., Dickinson, S. E., & Alberts, D. S. (2013) · Springer eBooks · doi:10.1007/978-3-642-38983-2_12 · Cited by 1
Invited Commentary: Indoor Tanning—A Melanoma Accelerator?
Berwick, M., & Doré, J. (2016) · American Journal of Epidemiology · doi:10.1093/aje/kww149 · Cited by 1
Self-citationKo, J., Geller, A. C., & Swetter, S. M. (2018) · doi:10.1002/9781118592168.ch34 · Cited by 1
Aspectos normativos de las camas solares
Glorio, R. R., & Carbia, S. G. (2013) · Dermatología Argentina
Malignant Tumors of the Skin and Subcutaneous Tissue in Children
Pappo, A. S., & Galindo, C. R. (2012) · doi:10.1002/9781118464557.ch70
Lymphovascular invasion in melanoma and breast cancer
Safuan, S. (2012) · Nottingham ePrints (University of Nottingham)
Malignant melanoma and other malignancies of the nasal cavity and the paranasal sinuses in Sweden
Jangard, M. (2014) · Figshare
Response to Letter Regarding Indoor Ultraviolet Radiation Tanning and Skin Cancer
Dellavalle, R. P., Karimkhani, C., Boyers, L. N., & Schilling, L. M. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.06.024
Metadata
- Authors
- Lazovich, D., Vogel, R. I., Berwick, M., Weinstock, M. A., Anderson, K. E., & Warshaw, E. M.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Lazovich, DeAnn
- ORCID
- Venue
- Cancer Epidemiology, Biomarkers & Prevention
- Published
- 2010-06-01
- Volume
- 19
- Issue
- 6
- Pages
- 1557-1568
- ISSN
- 1055-9965 (ISSN-L)
- 1538-7755
- PMC
- PMC2883000
- OpenAlex
- W2097779490
- Cited by
- 353
- References
- 60
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 3 · 2023: 3 · 2022: 13 · 2021: 13 · 2020: 15 · 2019: 15 · 2018: 21 · 2017: 30 · 2016: 28 · 2015: 21 · 2014: 33 · 2013: 42 · 2012: 40
- FWCI
- 23.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer Epidemiology Biomarkers & Prevention (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R01CA106807)
- Topics
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Health Sciences › Medicine › Dermatology › Skin Protection and Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › melanin and skin pigmentation
- Keywords
- indoor tanning, melanoma, tanning beds, dose-response relationship, sun exposure, melanoma risk factors
- MeSH terms
- Adult, Beauty Culture, Female, Humans, Male, Melanoma, Middle Aged, Minnesota, Surveys and Questionnaires, Risk Factors, Skin, Skin Neoplasms, Ultraviolet Rays, Case-Control Studies
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