Younger age at first use and more frequent use of indoor tanning beds are largely responsible for the steep increase in melanoma diagnoses in women younger than 40 years.

The study, published in JAMA Dermatology (doi:10.1001/jamadermatol.2015.2938), examined associations between indoor tanning use in men and women in Minnesota to better understand the female-specific increase in young adult (younger than 50 years) melanoma cases across the United States.

Melanoma is the most fatal skin cancer. Although melanoma is rare, its incidence is increasing dramatically, particularly among women younger than 50 years. Led by DeAnn Lazovich, MPH, PhD, associate professor of Epidemiology and Community Health at the University of Minnesota, in Minneapolis, the study examined the likelihood of melanoma in relation to the age when indoor tanning began and the frequency of indoor tanning as reported on melanoma diagnosis.

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A total of 681 patients age 25 to 49 years, including 465 women (68.3% female), with melanoma diagnosed between 2004 and 2007 were compared with 654 persons without melanoma (controls) age 25 to 49 years, including 446 women (68.2% female). Any tanning bed use, first age of use, and total sessions were assessed for significant associations with age at diagnosis (younger than 30 years, 30 to 39 years, 40 to 49 years) and with gender.

Women younger than 40 years at melanoma diagnosis reported more frequent tanning sessions (median 100 vs 40 sessions) and initiated tanning at a younger age (16 years vs 25 years) than women age 40 to 49 years at melanoma diagnosis. The youngest women were 6 times more likely to be in the melanoma group if they participated in indoor tanning.

“Our results indicate that these efforts need to be accelerated and expanded beyond bans on minor access to indoor tanning to curb the melanoma epidemic, which seems likely to continue unabated especially among young women, unless exposure to indoor tanning is further restricted and reduced,” the authors stated.

Results for men were inconclusive, due in part to less reporting of indoor tanning and to smaller sample sizes. This study indicates indoor tanning is a major determinant in the steeper increase in melanoma rates among younger women compared with men.