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Basal Cell Carcinoma at a Young Age: Another Consequence of Tanning Beds

Tanning bed users younger than 40 developed early-onset BCCs significantly more often than nonusers.

Over the past 4 decades, the incidence of basal cell carcinoma (BCC) has increased markedly, particularly in women under the age of 40. This increase coincides with the more frequent use by the public of tanning beds for cosmetic purposes. Estimates suggest as many as one third of teenagers in the U.S. have used tanning beds at least once, and 40% regularly use this means of tanning. Although good epidemiological evidence associates tanning bed use with cutaneous squamous cell carcinomas (SCCs) and melanomas, the effect on BCCs has been less certain. Investigators examined the development of BCCs in young tanning bed users.

The researchers compared interview responses by 376 patients with prior history of biopsy-proven BCC and 390 patients with other dermatological conditions (age, <40 in both groups). Men and women who had used indoor tanning beds at least once were significantly more likely than never-users to have early-onset BCC (BCC that develops before age 40; odds ratio, 1.69). The association between tanning bed use and early-onset BCC was greater in women than in men and greater in patients with multiple BCCs than in those with single BCCs. In multivariate analysis, this association grew stronger with increasing years of use. Researchers also identified a strong association between early-onset BCC and having had a tanning bed–induced burn. Compared with nonusers, tanning bed users were nearly four times more likely to have BCCs on the extremities and more than twice as likely to have BCCs on the trunk. Tanning bed users had no observable increase in BCCs on the head and neck, areas subject to considerably more ambient sun exposure. The authors estimated the percentages of early-onset BCCs that could have been prevented by tanning bed avoidance at 27% overall and 43% among women alone.

Comment: Few studies have evaluated the association between tanning bed exposure and basal cell carcinoma, and the results of existing studies are inconclusive because most included older individuals in the study population. This well-designed study was limited to assessment of the under-40 population that is most likely to use tanning beds. The observation that tanning bed use was associated with BCCs of the trunk and extremities highlights the importance of complete examinations of frequent tanning bed users, not only for BCCs but also for melanomas and squamous cell carcinomas of the skin.

— Craig A. Elmets, MD

Published in Journal Watch Dermatology February 3, 2012

Citation(s):

Ferrucci LM et al. Indoor tanning and risk of early-onset basal cell carcinoma. J Am Acad Dermatol 2011 Dec 8; [e-pub ahead of print]. (http://dx.doi.org/10.1016/j.jaad.2011.11.940)

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