Sunbeds and carcinogenesis: the need for new regulations and restrictions in Europe from the Euromelanoma perspective

Abstract

Experimental investigations have definitely assessed that ultraviolet A (UVA) as well as ultraviolet B (UVB) radiation induce mutagenic DNA photoproducts and other cell damages with a carcinogenic potential. Artificial tanning increases significantly the lifetime risk for basal cell carcinoma, squamous cell carcinoma and melanoma particularly in subjects with fair skin type, subjects with a history of skin cancer or frequent childhood sunburn or if exposures took place at an age younger than 18 years. In addition, experimental and clinical evidence indicate that UVA exposure promotes skin photoageing. Therefore we are dealing with a recreational activity (for customers) and a profitable business (for the tanning industry) with human costs, i.e. an increase in morbidity and mortality by skin cancer, and health and social costs leading to an increased expenditure by the European national health systems. In a few European countries, legislation has recently prohibited the use of sunbeds for minors, pregnant women, people with skin cancer or a history of skin cancer and individuals who do not tan or who burn easily from sun exposure. However, this legislation seems to be insufficient from a photobiological perspective, and importantly, it is largely disregarded by consumers and tanning industry. Therefore the Euromelanoma group proposes a new, more stringent regulation for the tanning industry and restrictions for customers, particularly for those individuals with constitutional and anamnestic risk factors. Finally, we ask for an enhanced commitment to increase the awareness of the general population on the risk of artificial tanning.

Sunbeds and Melanoma Risk: Many Open Questions, Not Yet Time to Close the Debate

“…Our analysis of the report of Suppa and Gandini (1) revealed severe weaknesses (Table I). The criticism previously addressed by us (8,9) and others (7) has not been adequately addressed in the report of Suppa and Gandini (1) or by others (2,3,5,6). The conclusions reported in those publications (1-3, 5, 6) are not sufficiently supported by present scientific knowledge and therefore are not in agreement with generally accepted principles of evidencebased medicine.…”

Management of cutaneous melanoma: comparison of the leading international guidelines updated to the 8th American Joint Committee on Cancer staging system and workup proposal by the Italian Society of Dermatology

“…6 Artificial UVA in tanning booth has been found to increase significantly the lifetime risk of melanoma because UVa as well as UVB radiations induces mutagenic dna photoproducts and other cell damages with a carcinogenic potential and artificial tanning is not photo-protective against further sun exposure. 7 People with fair complexion, blue gray or green eyes, red or blond hair, and lots of freckles are at higher risk of developing melanoma as compared to people with other skin types. in particular melanoma risk is almost double for all people with skin phototype ii and is 35% higher for people with skin phototype iii, always compared with the melanoma risk for those people having skin phototype iV.…”

An Epidemiological Update on Indoor Tanning and the Risk of Skin Cancers

“…Ultraviolet radiation (UVR), consisting predominantly of UVA (320–400 nm) and a small fraction of UVB (280–320 nm) wavelengths, is emitted by the sunlight and sunbed indoor tanning devices, and is responsible for tanning (natural or artificial tanning, respectively) [ 1 ]. In modern times, tanning (from the sun or sunbeds) presents as a wolf in sheep’s clothing.…”