Of 63,942 new cases of cutaneous melanoma (a form of skin cancer) diagnosed each year in Europe an estimated 3,438 (5.4%) are related to sunbed use. Sunbed users are at a 20% increased relative risk of skin cancer compared with those who have never used a sunbed. This risk doubles if they start before the age of 35 and experts warn that “tougher actions” are needed to reduce this risk.
Sun exposure is the most significant environmental cause of skin cancer and sunbeds have become the main non-solar source of UV exposure in Western Europe (UV is the wavelength associated with the occurrence of skin cancer). A study from 2005 found a 75% increased risk of melanoma if sunbed sessions were started during adolescence or early adulthood. But no studies since then have estimated the impact of melanomas (skin cancer tumours) due to sunbeds in Western Europe.
So researchers from the International Prevention Research Institute in France and the European Institute of Oncology in Italy analysed the results of 27 separate studies on skin cancer and sunbed use between 1981 and 2012. Countries included the UK, France and Germany.
The total number of skin cancer cases included in the analysis was 11,428. The authors summarised risk of skin cancer from any sunbed use at 20% which rose to 87% if exposure was before 35 years of age. There was also a 1.8% increase in risk for each additional sunbed session per year.
The authors estimate that from the 63,942 new cases of melanoma diagnosed every year in 18 Western European countries, 3438 and 794 deaths (498 women and 296 men) would be caused by sunbed use.
The authors believe that earlier studies have tended to underestimate the risks of indoor tanning because the use of these devices is relatively new. Furthermore, from 2005 to 2011, most risks have increased. Future studies could therefore demonstrate an even higher risk.
It could be argued that sunbed exposure could be a marker of a more sun exposed population, but figures from Iceland (where sunny days are uncommon) show that after 1990 the incidence of skin cancer increased sharply in young females which decreased in 2000 when authorities imposed greater control on sunbed installation.
The authors conclude that melanoma and other skin cancers associated with sunbed use can be prevented by avoiding exposure to indoor tanning devices. They argue that the sunbed industry has not shown an ability to “self-regulate effectively” but instead give “information intended to deceive consumers”. They argue that prevention must be based on “tougher actions” and that tanning under the age of 18 should be restricted and unsupervised tanning salons should be banned – laws that are already in place in Australia and several Europe countries. In the USA, only the State of California has introduced such a ban.
Mathieu Boniol, International Prevention Research Institute, Lyon, France
Philippe Autier, International Prevention Research Institute, Lyon, France