title: Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma.
abstract: Sunbed use is associated with increased risk of melanoma. Younger people might be more susceptible to the carcinogenic effects of ultraviolet radiation. We investigated the association between sunbed use and risk of early-onset cutaneous malignant melanoma. From the Australian Melanoma Family Study, a multicentre, population-based, case-control-family study, we analysed data for 604 cases diagnosed between ages 18 and 39 years and 479 controls. Data were collected by interview. Associations were estimated as odds ratios (ORs) using unconditional logistic regression, adjusting for age, sex, city, education, family history, skin color, usual skin response to sunlight and sun exposure. Compared with having never used a sunbed, the OR for melanoma associated with ever-use was 1.41 (95% confidence interval (CI) 1.01-1.96), and 2.01 (95% CI 1.22-3.31) for more than 10 lifetime sessions (P(trend) 0.01 with cumulative use). The association was stronger for earlier age at first use (P(trend) 0.02). The association was also stronger for melanoma diagnosed when aged 18-29 years (OR for more than 10 lifetime sessions = 6.57, 95% CI 1.41-30.49) than for melanoma diagnosed when 30-39 years (OR 1.60, 95% CI 0.92-2.77; P(interaction) 0.01). Among those who had ever used a sunbed and were diagnosed between 18 and 29 years of age, three quarters (76%) of melanomas were attributable to sunbed use. Sunbed use is associated with increased risk of early-onset melanoma, with risk increasing with greater use, an earlier age at first use and for earlier onset disease.
authors.affiliation: Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia. aecust@unimelb.edu.au
authors.forename: Anne E
authors.initials: AE
authors.lastname: Cust
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Armstrong
authors.forename: Chris
authors.initials: C
authors.lastname: Goumas
authors.forename: Mark A
authors.initials: MA
authors.lastname: Jenkins
authors.forename: Helen
authors.initials: H
authors.lastname: Schmid
authors.forename: John L
authors.initials: JL
authors.lastname: Hopper
authors.forename: Richard F
authors.initials: RF
authors.lastname: Kefford
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Joanne F
authors.initials: JF
authors.lastname: Aitken
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D055108:Sunbathing