Tanning beds linked to skin cancer in young people

The first rigorous study of an increasingly common form of skin cancer in young people finds that indoor tanning significantly increases the risk. This new study by Yale Cancer Center researchers finds that people who used indoor tanning beds are at a significantly higher risk of developing basal cell carcinoma (BCC) before the age of 40 than people who never used indoor tanning beds. BCC is an extremely common type of skin cancer, more frequent than all other forms of cancer combined. The findings are published online in the Journal of the American Academy of Dermatology.

Led by researchers from the Yale School of Public Health, the investigative team determined that young people who had tanned indoors had a 69 percent increased risk of early-onset BCC. The association was strongest among women, and the risk increased with years of indoor tanning use.

Recent data indicate that BCC incidence is on the rise, especially in young women.  Approximately a quarter of the overall cases of early-onset BCC — including 43 percent of cases in women — could be prevented if individuals never used indoor tanning beds, the research found.

“Indoor tanning was strikingly common in our study of young skin cancer patients, especially in the women, which may partially explain why 70 percent of early-onset BCCs occur in females,” said Susan T. Mayne, professor at the School of Public Health and the senior author of the study. “We were also surprised to find that one-third of our study participants with BCC had already had at least one additional BCC before age 40, which is very alarming as skin cancers increase in frequency with age.”

These results expand upon recent findings also linking indoor tanning to melanoma, a less common but more lethal form of skin cancer that is also increasing in young women.

“We routinely see young women with skin cancer in our practice. In the past this was extremely rare, but now in many cases the patients acknowledge their use of tanning parlors, and I think this study confirms the harmful nature of this activity,” said David J. Leffell, M.D., a study author and professor of dermatology and surgery and chief of the section of cutaneous oncology at Yale School of Medicine.

“Importantly, indoor tanning is a behavior that individuals can change. In conjunction with the findings on melanoma, our results for BCC indicate that reducing indoor tanning could translate to a meaningful reduction in the incidence of these two types of skin cancer,” said Leah M. Ferrucci, first author of the paper and a postdoctoral fellow at the School of Public Health.

In the United States alone, an estimated 30 million people use indoor tanning beds each year, with young women being the most likely to engage in the behavior. Ferrucci and co-authors concluded that both policy-based restrictions (such as legislation recently passed in California that bans tanning bed use by minors), as well as behavioral interventions, are needed to reduce indoor tanning.

The research team interviewed more than 750 people under the age of 40 with BCC and without. For the subjects who used indoor tanning beds, the researchers evaluated the frequency, duration, types of tanning devices used, the number of burns suffered from tanning, and the age at which the person started tanning.

Other members of the research team were Brenda Cartmel, Annette M. Molinaro, and Allen E. Bale, from the Yale Schools of Public Health and Medicine and Yale Cancer Center. This research was part of Yale’s Specialized Programs of Research Excellence (SPORE) in Skin Cancer.

The study was supported by the National Cancer Institute and the National Center for Research Resources of the National Institutes of Health.

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