The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review

Abstract

Exposure to solar ultraviolet (UV) radiation is a known cause of skin cancer. Sunbed use represents an increasingly frequent source of artificial UV exposure in light‐skinned populations. To assess the available evidence of the association between sunbed use and cutaneous malignant melanoma (melanoma) and other skin cancers, a systematic review of the literature till March 2006 on epidemiological and biological studies on sunbed use was performed in Pubmed, ISI Web of Science, Embase, Pascal, Cochrane library, Lilacs and Medcarib. Search for keywords in the title and in the abstract was done systematically and supplemented by manual searches. Only case–control, cohort or cross‐sectional studies were selected. Data were abstracted by means of a standardized data‐collection protocol. Based on 19 informative studies, ever‐use of sunbeds was positively associated with melanoma (summary relative risk, 1.15; 95% CI, 1.00–1.31), although there was no consistent evidence of a dose–response relationship. First exposure to sunbeds before 35 years of age significantly increased the risk of melanoma, based on 7 informative studies (summary relative risk, 1.75; 95% CI, 1.35–2.26). The summary relative risk of 3 studies of squamous cell carcinoma showed an increased risk. For basal cell carcinoma, the studies did not support an association. The evidence does not support a protective effect of the use of sunbeds against damage to the skin from subsequent sun exposure. Young adults should be discouraged from using indoor tanning equipment and restricted access to sunbeds by minors should be strongly considered. © 2006 Wiley‐Liss, Inc.

The Molecular Pathology of Melanoma: An Integrated Taxonomy of Melanocytic Neoplasia

“…Sun protection in children has been demonstrated to reduce nevus formation (100). The link between sun exposure in early life and nevus and melanoma risk has led to increased legislation to restrict access to tanning beds for minors, the use of which has been associated with melanoma risk (101). …”

Melanoma epidemiology, biology and prognosis

“…Long-term follow-up of psoriasis patients has demonstrated that those receiving UV-A therapy are at increased risk of developing melanoma [27]. Sunbeds emit UV-A radiation; a meta-analysis of studies [28] exploring melanoma incidence following sunbed use reported a 75% increase in risk in individuals under 35 with a history of sunbed use. Further studies support this finding, drawing clear associations between melanoma risk and the amount of sunbed usage, particularly from a young age [29–31].…”

Diversity of Biological Effects Induced by Longwave UVA Rays (UVA1) in Reconstructed Skin

“…In humans, UVA1 exposure during phototherapy sessions leads to acute side effects including skin dryness, pruritus, polymorphic light eruptions and herpes simplex virus reactivation [10], [11]. A potential carcinogenic effect in humans can be strongly suspected since these wavelengths are able to induce DNA lesions and mutagenesis, and an increasing risk towards melanoma has also been associated with use of sunbeds [5], [12], [13]. In addition, UVA1 wavelength range, in contrast to UVA2, is highly immunosuppressive in human in vivo and is thought to be the largest contributor to immunosuppression resulting from incidental daily sun exposure [14], [15].…”