Prom Tanning in '90s Behind Current Spike in Melanoma



NEW YORK – Teenage girls who used tanning beds in the 1990s are behind the sharp increase in melanoma in young women, according to Dr. Darrell S. Rigel.

The rise in melanoma from this often prom-driven surge in tanning has shown up as increased cases in women aged 25-34 years, Dr. Rigel said at the American Academy of Dermatology’s Summer Academy meeting.

"All the melanoma I see in women in their 20s and 30s, virtually every one of them has gone to a tanning salon, and we’re seeing a lot more" melanoma in women in this age group, said Dr. Rigel, a dermatologist at New York University. In addition, the primary melanomas seen in young women "often occur where the sun doesn’t shine but the tanning beds do," on breasts and near the genitalia, he said. "There definitely is a causal relationship."

Documentation of the rising rate of melanoma in young women includes data collected by the National Cancer Institute’s SEER (Surveillance, Epidemiology, and End Results) program. Data collected by SEER for U.S. melanoma incidence rates showed that during 2004-2006, white women aged 25-29 had a 14.3 per 100,000 incidence of melanoma, a 4% absolute and 42% relative jump from the rate in similarly aged women in 1994-1996. Among white women aged 30-34, the 2004-2006 SEER rate was 16.4 per 100,000 cases, also a 4% absolute and 32% relative jump from the rate in 1994-1996.

Recent increases in melanoma incidence among young white women have been "especially rapid," according to comments published earlier this year (J. Natl. Cancer Inst. 2011;103:171). Since 1995, the annual incidence of melanoma among young, white U.S. women rose by an average of 3.8%, compared with each preceding year.

Increased melanoma incidence since the 1990s links with the greater popularity of tanning beds among teens that first reached high levels in the 1990s. The first commercial U.S. tanning salon opened in 1978, and today there are about 60,000, with about 1 million Americans using a tanning bed daily and about 28 million using a tanning bed at least once each year, Dr. Rigel said. Women patronize tanning salons about sevenfold times more often than men, and other statistics show that more than a third of white, U.S. teens aged 17-18 have had a tanning session at least once in the prior year, he said.

"Major marketing is targeted at these women prior to proms," Dr. Rigel said in an interview. Young women aged 17-18 are "particularly susceptible," to the effects of artificial UV tanning radiation in the development of skin cancer. "This will take a broad sea change. We need models who are not tan in magazines aimed at young women. The pale look has to be in. It’s still cool to be tan. We’re working against that, and against their not being worried about skin cancer, and about how they’ll look at age 50. It’s just not there."

The spike in cases appearing in women once they have reached 25 years or older "is exactly when you’d expect to see the melanomas" based on high-level exposure at age 17-18, he added. The latency period from the time of intensified exposure to the appearance of melanoma is 5-20 years, he said.

"Twenty years ago, it was rare to see a woman in her 20s with melanoma, and we also did not see a lot among women in their 30s. Now, we commonly see cases in women in their 20s, and every one of them has a tanning history. The foremost issue for melanoma in women is tanning beds. For the first time, we’re seeing an increased incidence of melanoma in young women in their 20s and 30s, and the only thing they appear to do differently than young men is go to tanning salons."

Primary care physicians who see women in their 20s and 30s should examine their skin for signs of melanoma when they have the chance during physical examination, and should ask about a history of tanning-bed use. Results from several studies show that even a single tanning episode can significantly increase the risk for melanoma, so all a physician has to ask is, "Have you ever gone to a tanning salon?" to know whether a patient has an increased melanoma risk.

In addition to increased awareness, physicians need to educate teenage girls and the general public about the danger from tanning beds. "It’s very analogous to cigarette smoking. All we can do is get the word out, and hope that people do less harm to themselves."


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