Indoor tanning even one time increases the risk for skin cancer greatly. For example, one study found the risk for melanoma, the deadliest form of skin cancer, to be 74 percent greater among indoor tanners than non-tanners. Despite this, we know very little about skin cancer screening behavior among indoor tanners. Skin cancer screening can detect tumors when they are smaller, which is associated with better survival than later detection.
Previous research has shown that those who take part in indoor tanning are at a higher risk of developing melanoma and other skin cancers. With that, the U.S. Food and Drug Administration recommends those who take part in this activity be screened for skin cancer at regular intervals. Carolyn J. Heckman, Ph.D., a researcher in the Cancer Prevention and Control Program at Rutgers Cancer Institute of New Jersey explored if indoor tanners are getting themselves checked and taking other preventative measures as well. The research was recently published in the online edition of JAMA Dermatology.
Indoor Tanning And Skin Cancer
The team analyzed data from the National Health Interview Survey conducted with more than 30,000 U.S. adults. They looked at rates of skin cancer screening by a physician among people who had indoor tanned and those who had not. About 16.5 percent of the sample had indoor tanned, most of them more than a year ago. About 19.5 percent of non-indoor tanners had been screened for skin cancer, and a little more than 30 percent of indoor tanners had.
The team also explored which other sociodemographic, healthcare, as well as skin cancer risk and protective variables were associated with skin cancer screening and found many similar ones among the two groups – and some different ones. A key limitation is that data were collected at only one time-point, so they don’t know exactly when the screening occurred in relation to the indoor tanning.
The FDA recommends that indoor tanners be screened for skin cancer, but 70 percent of those who reported indoor tanning in this analysis have not done this. We need to develop ways to help providers and patients conduct this screening. For example, people with lower household incomes – less than $100,000 per year – were less likely to be screened, suggesting that making screening more accessible to this population might increase screening rates.
Men With Non-Melanoma Skin Cancer History Less Likely To Die Of Melanoma
Skin cancer survivors know firsthand that the disease is most treatable when detected early, so they’re more likely to be vigilant about skin exams. New research shows that such vigilance pays off. After studying more than 900 cases of melanoma reported through the Health Professionals Follow-up Study, researchers found that men with a history of nonmelanoma skin cancer were less likely to die of melanoma than those without an NMSC history. The research, led by Jiali Han, Ph.D., a professor and chair of epidemiology at the Indiana University Richard M. Fairbanks School of Public Health in Indianapolis, was published in the Journal of the American Academy of Dermatology.
“Our results highlight the impact of early detection on skin cancer survival,” says board-certified dermatologist Steven T. Chen, MD, MPH, FAAD, an assistant professor of dermatology at Harvard Medical School in Boston and a co-author of the JAAD study. “Because people who have been diagnosed with skin cancer are more likely to see a dermatologist for regular skin exams, any future skin cancers they may develop are more likely to be caught early, when they’re most treatable.”
“Melanoma is the deadliest form of skin cancer, killing one person every hour, so it’s great that NMSC survivors understand the importance of early detection,” says board-certified dermatologist Suzanne M. Olbricht, MD, FAAD, president of the American Academy of Dermatology. “However, regular skin self-exams are a habit that everyone, regardless of medical history, should adopt. While the five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 99 percent, the five-year survival rates for regional and distant stage melanomas are only 63 percent and 20 percent, respectively. Men over 50 have an increased risk of developing melanoma, so we hope this PSA reminds them to keep a close eye on their skin, Furthermore, we encourage everyone, regardless of age, race or gender, to perform regular skin self-exams and see a board-certified dermatologist if they notice any new or suspicious spots, or any spots that are changing, itching or bleeding.”
Research Highlights Importance Of Melanoma Prevention, Early Detection
Melanoma, the deadliest form of skin cancer, can affect anyone. Everyone should take steps to reduce their risk and catch melanoma in its earliest stages, when it’s most treatable. Research presented by the American Academy of Dermatology emphasizes the importance of skin cancer prevention and detection. Researchers examined data collected from 118,085 individuals who received a free skin cancer screening. Approximately one-third of those surveyed indicated that they had recently observed a change in the size, shape or color of a mole – one of the major warning signs of melanoma.
“This result is encouraging, because it shows us that patients are keeping an eye out for suspicious spots on their skin, and that they know to see a board-certified dermatologist to evaluate those spots,” says board-certified dermatologist Hensin Tsao, MD, PhD, FAAD, a professor of dermatology at Harvard Medical School. Melanoma is most treatable when detected early, so the AAD recommends performing regular skin self-exams to look for new or suspicious spots. The AAD also recommends seeing a board-certified dermatologist to evaluate anything changing, itching or bleeding on the skin. Because unprotected exposure to ultraviolet light is the most preventable skin cancer risk factor, the AAD advises everyone to stay out of indoor tanning beds and protect themselves from the sun’s harmful rays by seeking shade, wearing protective clothing and using a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher.
Measuring Melanoma Risks
In compiling the survey data, researchers found that infrequent sunscreen use, high numbers of blistering childhood sunburns and chronic indoor tanning bed use were all associated with a recently changing mole. “These results indicate that although people know how to spot skin cancer, they aren’t taking action to prevent this disease from developing in the first place,” Dr. Tsao says. “While some individuals have a higher risk of developing melanoma than others, everyone increases their risk when they don’t protect their skin from harmful UV rays.”
The risk of developing melanoma is elevated among certain groups, including Caucasians, men over 50, people with a personal or family history of skin cancer, and those with many moles, atypical moles or large moles. Among the screening participants studied, however, the factors associated with a changing mole included not only a high mole count and a history of melanoma, but also being female and having skin of color. “While Caucasian men over 50 are at greatest risk for developing melanoma, skin cancer can affect anyone, so prevention and detection should be a priority for everyone,” Dr. Tsao says. “No matter your age, race or gender, it’s important to avoid harmful UV exposure from the sun and indoor tanning beds, and to perform regular skin self-exams so you can detect this disease early, when it’s most treatable. If you notice any new, unusual or changing spots on your skin, see a board-certified dermatologist. If you’re in any of the groups that are predisposed to melanoma, including those with many moles and those with a family history of skin cancer, talk to your dermatologist about how often you should receive a skin exam.”
How Much Sun Is Good For Our Health?
Spanish researchers have estimated the duration of solar radiation exposure required in order to obtain the recommended doses of vitamin D. While in spring and summer 10 to 20 minutes in the sun is enough, in the winter months almost two hours would be needed. For the vast majority of the population it is difficult to achieve the optimal values.
Every year, studies on the benefits of sunbathing in moderate doses are interspersed with those that confirm the risks of doing it excessively. Although ultraviolet solar radiation contributes to the development of sun erythema, cancer and aging of the skin, it also reduces blood pressure, synthesizes vitamin D and improves the treatment of several diseases. The Solar Radiation Research Group at the Polytechnic University of Valencia has analyzed the exposure time needed to obtain the recommended doses of vitamin D without damaging our health. The results have been published in the journal Science of the Total Environment.
As María Antonia Serrano, a scientist at the UPV and main author of the study, explains: “In Spain, despite being a country with many hours of sunlight, several articles have reported a high percentage of vitamin D deficiency among various strata of the Spanish population.” Vitamin D deficiency is linked in adults to a higher risk of suffering from various diseases. Since very few foods contain this vitamin, its synthesis in the skin as a result of sun exposure is the main natural source that exists.
Serrano and her colleagues estimated the time needed to obtain the recommended doses – equivalent to a daily intake of 1,000 international units of vitamin D – in an area such as the city of Valencia, which receives a large dose of UV radiation throughout the year.
Burning In 30 Minutes
The study analyzed ultraviolet solar irradiance around midday for four months of the year – one in each season – from 2003 to 2010. With these figures the time taken to cause erythema – reddening of the skin caused by burns – was calculated. The facts show that in July, an individual with skin type III – the most common among the population of Spain – must not spend more than 29 minutes in the sun if they wish to avoid erythema. However, in January, the same individual can remain in the sun for 150 minutes.
The minimum exposure time to obtain the recommended daily dose of vitamin D was obtained the same way. The problem can appear in winter due to low levels of UV radiation and because people cover most of their bodies. It was found that around midday in January, with 10 percent of the body exposed, around 130 minutes are needed to obtain the recommended daily dose of vitamin D.
As this time is shorter than the time taken to get erythema, there is no risk of sunburn. By contrast, in April and July, with 25 percent of the body exposed, around 10 minutes is sufficient to acquire the vitamin. And in October, for example, 30 minutes would be enough. “These calculations were made for skin type III, but the figures would change for those who are lighter or darker in complexion,” Serrano points out. “It is also essential to bear in mind that we have considered the usual percentage of the body exposed for the season. If more skin is exposed, exposure time can be reduced.”
Similarly, the time obtained for erythema to occur was calculated for average days. “It should be taken with caution. On extreme days, permissible exposure times would be much shorter,” she stresses.
Maintaining Vitamin D In Winter
The results show that, although there is sufficient radiation in countries like Spain, it is difficult to attain recommended doses of vitamin D in winter – from November to February at a northern mid-latitude, since the exposure time required is excessive – 130 minutes. “Radiation received also depends on posture, body shape and clothing. It should also be remembered that not all areas of the body synthesize vitamin D with the same efficiency,” Serrano added. “An individual’s age also plays an important role in synthesizing vitamin D from UV radiation, because the older one gets the less able one is able to produce vitamin D. Middle-aged adults have 66 percent of the potential that children have to do this. These results can help to adopt the right measures to make up for any deficiency, such as informing the medical profession about the utility of increasing vitamin D intake in the diet or through supplements.”