Tanning bed and nail lamp use and the risk of cutaneous malignancy: a review of the literature

Our plain-English summary of Tanning bed and nail lamp use and the risk of cutaneous malignancy: a review of the literature, by N.A. O'Sullivan, C.P. Tait (The Australasian Journal of Dermatology, 2014).

The study

• Authors: N.A. O'Sullivan, C.P. Tait
• Journal: The Australasian Journal of Dermatology
• Published: 2014;55(2):99-106
• Type of article: Review
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant melanoma (MM) and non-melanoma skin cancer (NMSC) are increasingly common and both can be fatal. In 2009 the World Health Organization (WHO) classified the whole ultraviolet spectrum and tanning beds as carcinogenic to humans, placing them in the same category as asbestos and tobacco. Despite this, the trend for indoor tanning continues. A growing body of evidence has now associated indoor tanning with an increased risk of MM and NMSC. As a result, there has been an upsurge in regulations in the tanning industry ranging from age restrictions to complete bans on commercial tanning. This article examines the evidence and strengthens the case for a complete ban of a recognised modifiable risk factor for cutaneous malignancy.

© 2014 The Australasian College of Dermatologists.

In plain English

This article was a narrative review, not a study of asbestos. It examined published research on tanning beds, sunlamps and UV nail lamps and the risk of skin cancer. The authors searched PubMed, Embase and Google. Asbestos appears only because the World Health Organization in 2009 placed ultraviolet radiation and tanning beds in the same cancer category as asbestos and tobacco. The review reported results from other researchers' studies. A 2012 meta-analysis found that ever using indoor tanning devices increased the risk of melanoma by 20%. An International Agency for Research on Cancer meta-analysis reported a relative risk of 1.75 (95% CI 1.35 to 2.26) for melanoma in people first exposed to tanning beds before age 35. A 2012 meta-analysis of 12 studies found that ever using indoor tanning increased the risk of squamous cell carcinoma by 67% and basal cell carcinoma by 29%. For nail lamps, one cited study found the risk of squamous cell carcinoma was very low, but the authors said evidence there was scarce. The authors noted that most studies were observational and retrospective. They concluded that the research supported a complete ban on indoor tanning.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of the literature
• Who was studied: No study population of its own. The authors reviewed published literature found through PubMed (1966 onward), Embase (1974 onward) and a Google search.
• Exposure: Artificial ultraviolet radiation from tanning beds, sunlamps and solaria, and from UV lamps used to dry nail polish. Asbestos is mentioned only as the WHO category in which tanning beds were placed.
• Main results:
  • A 2012 systematic review and meta-analysis by other researchers, cited by this review, found that ever use of indoor tanning devices increased the risk of cutaneous melanoma by 20%.
  • An IARC meta-analysis, cited by this review, found that people first exposed to tanning beds before age 35 had a relative risk of melanoma of 1.75 (95% CI 1.35 to 2.26).
  • A 2012 meta-analysis by other researchers of 12 studies with 9328 cases of non-melanoma skin cancer, cited by this review, found that ever exposure to indoor tanning increased the risk of squamous cell carcinoma by 67% and basal cell carcinoma by 29%.
  • For UV nail lamps, a mathematical modelling study by Diffey and colleagues, cited by this review, found that the risk of squamous cell carcinoma from UVA nail lamp exposure was very low. The authors said evidence in this area remained scarce.
• The authors' conclusion: The authors concluded that the research to date supported a complete ban on indoor tanning.
• Limitations the authors state:
  • Most of the studies reviewed were observational and retrospective.
  • The spectral output of tanning devices changed over time, so study subjects may not have had comparable exposures.
  • Results may be confounded by skin type.
  • Risks in recent studies may have been underestimated because too little time had passed between exposure and diagnosis.
  • Evidence on UV nail lamps was scarce and further research was needed.

Topics

Medical terms in this study, explained in our Lexicon: Carcinogenic.

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