Indoor tanning associated with poor outdoor sun protection practices

Adults who frequently tanned indoors - a practice associated with an increased risk for melanoma - also practiced poor outdoor sun protection practices and were not more likely to undergo skin cancer screening, according to a new study published online by JAMA Dermatology.

Alexander H. Fischer, M.P.H., of the Johns Hopkins University School of Medicine, Baltimore, and coauthors used 2015 National Health Interview Survey data for a study population of 10,262 non-Hispanic white adults ages 18 to 60 without a history of skin cancer. The analysis was limited to non-Hispanic white adults because of their high prevalence of indoor tanning and high incidence of skin cancer.

Among 10,262 adults (49 percent female), 787 (7.0 percent) reported having tanned indoors within the past year; 3.6 percent reported moderate indoor tanning (1 to 9 times in the past year) and 3.4 percent reported frequent indoor tanning (10 times or more in the past year).

According to the results:

• In the overall study population, more frequent tanning bed use was associated with poor use of sunscreen, protective clothing and shade and it was associated with having had multiple sunburns in the past year, according to study results.
• Among young people 18 to 34, those who frequently tanned indoors were more likely to report rarely/never wearing protective clothing and rarely/never seeking shade on a warm sunny day compared with those who did not tan indoors.
• Women who frequently tanned indoors were more likely to report rarely/never applying sunscreen, rarely/never wearing protective clothing, rarely/never seeking shade and multiple sunburns in the past year compared with women who did not tan indoors.
• Men who frequently tanned indoors were more likely to rarely/never seek shade seek shade and men who moderately tanned indoors were more likely to rarely/never use protective clothing and to report multiple sunburns in the past year compared with men who did not tan indoors.
• People who tanned indoors were not more likely to have undergone a full-body skin examination compared with those adults who do not tan indoors.

Limitations of the study include the self-reported nature of the data.

"These results demonstrate that many individuals who tan indoors may not acknowledge the long-term risks associated with increased UV exposure. Thus, these findings highlight the importance of not only emphasizing avoidance of indoor tanning in public health messages and physician communication, but also reiterating the need for sun protection and skin cancer screening in this population," the study concludes.