title: Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis.
abstract: OBJECTIVE
  To estimate the burden of melanoma resulting from sunbed use in western Europe.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  PubMed, ISI Web of Science (Science Citation Index Expanded), Embase, Pascal, Cochrane Library, LILACS, and MedCarib, along with published surveys reporting prevalence of sunbed use at national level in Europe.
  
  
  METHODS
  Observational studies reporting a measure of risk for skin cancer (cutaneous melanoma, squamous cell carcinoma, basal cell carcinoma) associated with ever use of sunbeds.
  
  
  RESULTS
  Based on 27 studies ever use of sunbeds was associated with a summary relative risk of 1.20 (95% confidence interval 1.08 to 1.34). Publication bias was not evident. Restricting the analysis to cohorts and population based studies, the summary relative risk was 1.25 (1.09 to 1.43). Calculations for dose-response showed a 1.8% (95% confidence interval 0% to 3.8%) increase in risk of melanoma for each additional session of sunbed use per year. Based on 13 informative studies, first use of sunbeds before age 35 years was associated with a summary relative risk of 1.87 (1.41 to 2.48), with no indication of heterogeneity between studies. By using prevalence data from surveys and data from GLOBOCAN 2008, in 2008 in the 15 original member countries of the European Community plus three countries that were members of the European Free Trade Association, an estimated 3438 cases of melanoma could be attributable to sunbed use, most (n=2341) occurring among women.
  
  
  CONCLUSIONS
  Sunbed use is associated with a significant increase in risk of melanoma. This risk increases with number of sunbed sessions and with initial usage at a young age (<35 years). The cancerous damage associated with sunbed use is substantial and could be avoided by strict regulations.
authors: International Prevention Research Institute, 95 cours Lafayette, 69006 Lyon, France. mathieu.boniol@i-pri.org
authors: Mathieu
authors: M
authors: Boniol
authors: Philippe
authors: P
authors: Autier
authors: Peter
authors: P
authors: Boyle
authors: Sara
authors: S
authors: Gandini
mesh_terms: D000367:Age Factors; D004307:Dose-Response Relationship, Radiation; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000209:etiology; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology; D055108:Sunbathing / Q000639:trends; D014466:Ultraviolet Rays / Q000009:adverse effects*