title: Exposure to indoor tanning without burning and melanoma risk by sunburn history.
abstract: Indoor tanning is carcinogenic to humans. Individuals report that they tan indoors before planning to be in the sun to prevent sunburns, but whether skin cancer is subsequently reduced is unknown. Using a population-based case-control study, we calculated the association between melanoma and indoor tanning after excluding exposed participants reporting indoor tanning-related burns, stratified by their number of lifetime sunburns (0, 1-2, 3-5, >5). Confounding was addressed using propensity score analysis methods. All statistical tests were two-sided. We observed increased risk of melanoma across all sunburn categories for participants who had tanned indoors without burning compared with those who never tanned indoors, including those who reported zero lifetime sunburns (odds ratio = 3.87; 95% confidence interval = 1.68 to 8.91; P = .002). These data provide evidence that indoor tanning is a risk factor for melanoma even among persons who reported never experiencing burns from indoor tanning or outdoor sun exposure.
authors.affiliation: Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW).
authors.forename: Rachel Isaksson
authors.initials: RI
authors.lastname: Vogel
authors.affiliation: Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW).
authors.forename: Rehana L
authors.initials: RL
authors.lastname: Ahmed
authors.affiliation: Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW).
authors.forename: Heather H
authors.initials: HH
authors.lastname: Nelson
authors.affiliation: Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW).
authors.forename: Marianne
authors.initials: M
authors.lastname: Berwick
authors.affiliation: Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW).
authors.forename: Martin A
authors.initials: MA
authors.lastname: Weinstock
authors.affiliation: Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW). lazov001@umn.edu.
authors.forename: DeAnn
authors.initials: D
authors.lastname: Lazovich
mesh_terms: D000328:Adult; D001505:Beauty Culture; D016022:Case-Control Studies; D004249:DNA Damage / Q000528:radiation effects; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000209:etiology*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000209:etiology*; D055108:Sunbathing; D013471:Sunburn / Q000150:complications*; D014466:Ultraviolet Rays / Q000009:adverse effects*