Tanning Beds and the Rising Incidence of Basal Cell Carcinoma in Women

Even a little tanning bed exposure can increase skin cancer risk.


Definitive evidence links tanning bed use to increased melanoma risk, but links to nonmelanoma skin cancer, particularly basal cell carcinoma (BCC), are less clear. These investigators conducted a prospective-retrospective, mixed-cohort analysis of early tanning bed use and incident skin cancer among nearly 74,000 participants in the Nurses' Health Study II .

Over the 20-year follow-up period, BCC was diagnosed in 5506 women, squamous cell carcinoma (SCC) in 403, and melanoma in 349. For participants who used tanning beds four times per year, the multivariable hazard ratio was 1.15 for BCC, 1.15 for SCC, and 1.11 for melanoma. A dose–response relationship between tanning bed frequency and skin cancer incidence was seen: Six-times-per-year tanners were more likely to develop BCCs than four-times-per-year tanners. The association with BCC persisted after controlling for patient risk factors, outdoor tanning behavior, and the ultraviolet (UV) index of the state of residence. Increased BCC incidence was more strongly linked to tanning bed use during high school and college, whereas tanning bed use from age 25 to 35 had a greater impact on SCCs. No difference in risk was seen between high- and low-pigment subjects. Until the late 1970s, tanning beds emitted both UVB and UVA radiation; newer tanning beds emit only UVA. Nevertheless, similar skin cancer risks were seen with earlier and later models, indicating that contemporary tanning devices are not safer.

Citation(s):

Zhang M et al. Use of tanning beds and incidence of skin cancer. J Clin Oncol 2012 Feb 27; [e-pub ahead of print].