Original Investigation
March 2016

Association Between Indoor Tanning and Melanoma in Younger Men and Women

Author Affiliations
  • 1Masonic Cancer Center, University of Minnesota, Minneapolis
  • 2Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
  • 3Center for Dermatoepidemiology, VA Medical Center, Providence, Rhode Island
  • 4Department of Dermatology, Rhode Island Hospital, Providence
  • 5Department of Dermatology and Epidemiology, Brown University, Providence, Rhode Island
  • 6Department of Dermatology, University of Minnesota, Minneapolis
  • 7Department of Internal Medicine, University of New Mexico Cancer Center, Albuquerque
  • 8Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Dermatol. 2016;152(3):268-275. doi:10.1001/jamadermatol.2015.2938

Importance  In the United States and Minnesota, melanoma incidence is rising more steeply among women than men younger than 50 years. To our knowledge, no study has examined age- and sex-specific associations between indoor tanning and melanoma to determine if these trends could be due to greater indoor tanning use among younger women.

Objective  To examine associations between indoor tanning and melanoma among men and women younger than 50 years.

Design, Setting, and Participants  Population-based case-control study conducted in Minnesota of 681 patients (465 [68.3%] women) diagnosed as having melanoma between 2004 and 2007, and 654 controls (446 [68.2%] women), ages 25 to 49 years.

Exposure  Indoor tanning, defined as any use, first age of use, and total sessions.

Main Outcomes and Measures  Crude and adjusted odds ratios (ORs) and 95% CIs were calculated for melanoma in relation to indoor tanning exposure for men and women by diagnosis or reference age (<30, 30-39, 40-49 years). Sex-specific associations for indoor tanning and melanoma by anatomic site were examined.

Results  Compared with women aged 40 to 49 years, women younger than 40 years initiated indoor tanning at a younger age (16 vs 25 years, P < .001) and reported more frequent indoor tanning (median number of sessions, 100 vs 40, P < .001). Women younger than 30 years were 6 times more likely to be in the case than the control group if they tanned indoors (crude OR, 6.0; 95% CI, 1.3-28.5). Odds ratios were also significantly elevated among women, ages 30 to 49 years (adjusted OR, 3.5; 95% CI, 1.2-9.7 for women 30-39 years; adjusted OR, 2.3; 95% CI, 1.4-3.6 for women 40-49 years); a dose response was observed among women regardless of age. Among men, results by age were inconsistent. The strongest OR for indoor tanning by anatomic site was for melanomas arising on the trunk of women (adjusted OR, 3.7; 95% CI, 1.9-7.2).

Conclusions and Relevance  Indoor tanning is a likely factor for the steeper increase in melanoma rates in the United States among younger women compared with men, given the timing of when women initiated indoor tanning relative to diagnosis. The melanoma epidemic can be expected to continue unless indoor tanning is restricted and reduced.