Study links tanning bed use to rising melanoma rates in New England

Melanoma accounts for only 1% of skin cancers in the United States but results in the largest number of skin cancer deaths. Investigators evaluated the potential link between the availability and use of tanning beds and the rising rates of melanoma in New England. They found compelling evidence linking tanning bed usage to increased melanoma risk. Their spatial epidemiologic study in the Journal of Investigative Dermatology, published by Elsevier, provides critical insights to inform public health strategies and reduce melanoma incidence.

The incidence of melanoma in the US has been increasing over the past two decades. Melanoma incidence continues to increase at about 1% each year among females, while it has stabilized in men. Many factors contribute to a region's incidence of melanoma; the most preventable risk factor is ultraviolet (UV) radiation from both natural sources like solar radiation and artificial sources like tanning beds.

Lead investigator Oliver Wisco, DO, Associate Professor of Dermatology, Warren Alpert Medical School of Brown University and co-first authors Megan M. Tran, Department of Dermatology, Warren Alpert Medical School of Brown University, and Guixing Wei, PhD, Spatial Structures in the Social Sciences, Population Studies and Training Center, Brown University, explain, "Our patients are our primary source of inspiration for this research. Every day, we encounter patients diagnosed with melanoma. Witnessing the devastating impact of this disease drives us to find ways to prevent it. Despite the well-known dangers of UV radiation, access to tanning beds remains widespread, and their usage continues to be prevalent in many regions. This reality compelled us to investigate the potential link between the availability and use of these facilities and the rising rates of melanoma. Our goal was to better understand whether areas with greater access to tanning beds also experience higher rates of melanoma, with the hope that this knowledge could inform more effective public health strategies to combat skin cancer."

Investigators evaluated the geospatial relationship between melanoma incidence and access to tanning bed facilities at the county level in New England (2014-2018). They obtained melanoma incidence rates, tanning bed facilities locations, and demographic, socioeconomic, and geographic data from the National Cancer Institute State Cancer Profiles, Data Axle, American Community Survey, and United States Geological Survey.

The study revealed a significant association between greater access to tanning bed facilities and increased rates of melanoma in the New England region of the US. Investigators identified six high-risk clusters, seven low-risk clusters, and one outlier of melanoma incidence. Adjusted spatial regression identified that for every one-minute increase in average travel time to tanning facilities within a 30-minute travel time threshold, the melanoma incidence rate decreased by 3.46% in the same county and 1.92% across New England. These results suggest that people in regions with more tanning bed facilities may experience higher incidences of melanoma.

Dr. Wisco notes, "Although we anticipated finding a connection between tanning beds and melanoma, the strength of the association was more pronounced than expected. Our findings add to the growing body of evidence linking tanning bed usage to increased melanoma risk. These results provide critical insights to inform public health strategies aimed at reducing tanning bed use and ultimately, melanoma incidence. We hope to empower individuals to make informed decisions about their skin health and protect themselves from this disease."

The research team concludes, "Despite growing awareness of skin cancer risks, melanoma continues to be a major public health concern. Our research offers compelling geographic evidence linking access to tanning beds to this deadly disease. The negative association between travel time to tanning facilities and county-level melanoma incidence rate suggests that decreasing access to indoor tanning facilities may help reduce the regional melanoma incidence rate. Future registries should consider capturing data on tanning bed usage to help refine and target melanoma prevention efforts. However, additional research with detailed tanning behavioral data is needed."

Commenting on the study, noted expert David E. Fisher, MD, PhD, Massachusetts General Hospital (MGH), Harvard Medical School, and Director of the Melanoma Program, MGH Cancer Center and Cutaneous Biology Research Center, MGH, adds: "Melanoma is one of the relatively few human cancers for which a common, preventable cause is well documented: UV radiation. This study helps clarify the linkage between tanning beds and melanoma and helps us focus on how policies aimed at limiting tanning bed use may hopefully further diminish melanoma risk."