Tanning beds cause skin cancer

A research review published in JAMA Internal Medicine, an international peer-reviewed journal, has shown that tanning beds could lead to a higher risk of skin cancer, including melanoma. The review has highlighted again the need for health authorities globally to take heed of this health threat.

This is the first summary of the international prevalence of indoor tanning exposure. 88 records (studies) were included in the meta-analysis, and the results include data from 406,696 participants. Analyses were performed separately for three geographic regions: the United States and Canada, Northern and Western Europe and Australia, as well as for these regions combined.

The research found the number of skin cancer cases due to tanning is higher than the number of lung cancer cases due to smoking. In the US alone, 419,254 cases of skin cancer can be attributed to indoor tanning. Out of this number, 6,199 are melanoma cases.

Commenting on the review, The Skin Cancer Foundation in the US said: “The study results demonstrate that tanning bed use, particularly among young people, is an alarmingly widespread behavior. In the US, 35% of adults and 55% of college students have tanned, and the study found there are more than 419,000 new skin cancer cases attributable to indoor tanning each year. Worldwide, there are more skin cancer cases due to indoor tanning than there are lung cancer cases due to smoking. These results are not surprising given what we know about indoor tanning behaviors and society’s flawed view that an artificially tanned look is beautiful.”

Data from the National Cancer Institute in the US confirms the incidence rate of melanoma in women under 40 has risen by a third since the early 1990s. A Mayo Clinic study also reports similar trends, indicating that between 1970 and 2009, the incidence of melanoma increased eightfold among young women and fourfold among young men ages 18 to 39. And in 2009 the International Agency of Research on Cancer declared tanning beds a human carcinogen, and moved them into the top cancer-risk category, along with cigarettes.

“We’re seeing younger and younger patients coming to us with skin cancer,” Dr. Eleni Linos, assistant professor of dermatology at the University of California, San Francisco told the New York Times.

Sun Beds

“The surgeon general in the United States called on Americans to reduce their exposure to the sun and tanning beds to prevent skin cancer, and the Food and Drug Administration invoked its most serious risk warning, lifting tanning beds from a category that included Band-Aids to that of potentially harmful medical devices. The Obama administration’s 2010 health care law imposed a little-noticed 10 percent tax on tanning salons. And more than 40 states now have some sort of restriction on the use of tanning salons by minors, according to AIM at Melanoma, an advocacy and research group based in California, the first state to adopt a ban on minors in 2011. At least nine states plus the District of Columbia (pending congressional approval) have passed such bans, even Republican-controlled Texas, where antipathy to government regulation runs deep.”

So what is ultraviolet radiation and why is it so dangerous? There are different types of radiation, each consisting of different lengths of waves, which penetrate objects at certain levels. According to CANSA in South Africa, ultraviolet (UV) light is radiation of which the wavelength is slightly shorter and at the end of the visible spectrum. It’s a very energetic wavelength and can break chemical bonds, make molecules unusually reactive or ionise them – in general, changing their mutual behaviour.

Sunburn, for example, is caused by the disruptive effects of UV radiation on skin cells, which can cause skin cancer by damaging the complex DNA molecules in the skin cells. There are three types of UV radiation: UVA is the longest ray and penetrates the skin the deepest. It is responsible for causing aging, wrinkles and loss of elasticity. UVB is slightly shorter, and this is the ray that causes you to burn. It is also primarily the ray that contributes to skin cancer. UVC is the shortest and is very dangerous; it could quickly turn the earth into a dead desert, but luckily for us, most of it is absorbed by the atmosphere’s ozone layer before reaching the surface of the earth.

The health effects of UV radiation are staggering. The World Health Organization (WHO) reports that between two and three million non-melanoma skin cancers, and approximately 132 000 malignant melanomas, occur globally every year. Even though UVB radiation has been linked to skin cancers, including melanoma, researchers at the University of Texas MD Anderson Cancer Center have found that the risk of developing melanoma is only partially associated with exposure to UVB radiation, and is in fact exacerbated by the UVA rays.

Dr Noori Moti-Joosub, a dermatologist at Laserderm, explained to Longevity how tanning beds work: “They contain fluorescent tubes that emit UVA radiation. This ray causes initial tanning by photo-oxidation of melanin’s and the redistribution of melanosomes. Persistent tanning results from melanogenesis which is increased activity and number of melanosomes”. She also points out that the WHO has classified tanning beds as Group 1 carcinogen, and that people who use indoor tanning beds before the age of 35 have an increased risk of developing melanoma. It has been proven there is a relationship between the excessive use of sun beds and malignant melanoma, as well as other non-melanoma skin cancers. Sun beds predominantly emit UVA and UVB rays, both of which can cause damage in the DNA of skin cells.”

According to Professor Werner Sinclair, a dermatologist associated with the University of the Free State, “in general, one can state that the use of an artificial tanning booth will double the melanoma risk of any particular individual”.

Dermalogica’s communications manager Sonette Donker, confirmed the risk, saying a single session on a tanning bed is said to be equivalent to two full weeks of the sun’s UVA absorption.

Moti-Joosub said tanning beds can also worsen the prognosis of melanoma as often relatively “thick” melanomas develop in patients who have exposed themselves to a tanning bed. “Overexposure to UV radiation before the age of 18 leads to an increased risk for skin cancer later in life.”

Researchers attribute the growing use of sunbeds among young women to the need to fit into a desired image of having a healthy tanned look, as portrayed widely in the media by celebrities and the beauty and fashion industry. Young women interviewed in a C.D.C Youth study in the US said sun bed tanning fed a craving to be pretty and made them feel more confident.

More alarmingly many of the women interviewed admitted they were aware of health risks, but cared more about how they looked now. The C.D.C.’s National Youth study also found that indoor tanning often goes along with binge drinking and unhealthy weight-control practices. Among teenage girls, it was associated with illegal drug use and having sex with four or more partners, and among boys with the use of steroids, daily cigarette smoking and attempted suicide. Boys also tan indoors, but their numbers are a small fraction of the total.

Beach body babe

Skin cancer in general is on the increase globally. Among people with a history of melanoma, 27.3% report to never using sunscreen when in the sun, despite the fact that these lotions can help protect against skin cancer.

In South Africa, the Cancer Association of South Africa (CANSA) confirms skin cancer is the most common form of cancer in South Africa. Risk levels for South Africans are among the highest worldwide with melanoma – the most deadly type of skin cancer – on the rise.

Skin Cancer

Locally medical workers note there are lower levels of awareness of the dangers of tanning beds. Many, especially younger women who use tanning beds, are still unaware of the real risks, thinking that a simple 10 to 15 minutes of unnatural, unprotected sun is doing nothing more than giving them a healthy glow.

In 2013 CANSA called for tanning beds to be strictly regulated in South Africa and a total ban on the use of tanning beds by individuals younger than 18. However, South African legislation has lagged on the global trend to take action against this health threat.

Australia is the latest country to institute a “>ban on commercial tanning beds to minors effective from January 2015. The country follows several European countries and American states who have banned the use of sunbeds by minors.

This review was compiled with the editorial input of Longevity contributors – Candice Tehini and Gugu Mdima and other referenced sources.