title: Indoor Tanning and Melanoma Risk: Long-Term Evidence From a Prospective Population-Based Cohort Study.
abstract: Indoor tanning is associated with increased risk of melanoma, but most evidence comes from case-control studies. Using data from the Norwegian Women and Cancer Study, a large prospective cohort study, we investigated the associations of age at initiation of indoor tanning, duration of tanning-device use, and dose response with melanoma risk and examined the role of indoor tanning in age at melanoma diagnosis. We used Poisson regression to estimate relative risks and 95% confidence intervals for the relationship of indoor tanning to melanoma risk and linear regression to examine age of indoor tanning initiation in relation to age at diagnosis. During follow-up of 141,045 women (1991-2012; mean duration follow-up = 13.7 years), 861 women were diagnosed with melanoma. Melanoma risk increased with increasing cumulative number of tanning sessions (for highest tertile of use vs. never use, adjusted relative risk = 1.32, 95% confidence interval (CI): 1.08, 1.63); P-trend = 0.006. Age at initiation <30 years was associated with a higher risk in comparison with never use (adjusted relative risk = 1.31, 95% CI: 1.07, 1.59). Moreover, women who started indoor tanning prior to 30 years of age were 2.2 years (95% CI: 0.9, 3.4) younger at diagnosis, on average, than never users. This cohort study provides strong evidence of a dose-response association between indoor tanning and risk of melanoma and supports the hypothesis that vulnerability to the harmful effects of indoor tanning is greater at a younger age.
authors.affiliation: Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Blindern,Oslo, Norway.
authors.forename: Reza
authors.initials: R
authors.lastname: Ghiasvand
authors.affiliation: Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway.
authors.forename: Corina S
authors.initials: CS
authors.lastname: Rueegg
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: QIMR Berghofer Medical Research Institute, Cancer and Population studies, Brisbane, QLD, Australia; CRUK Manchester Institute and University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.
authors.forename: Adele C
authors.initials: AC
authors.lastname: Green
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.affiliation: Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway.
authors.forename: Marit B
authors.initials: MB
authors.lastname: Veierød
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D005260:Female; D006801:Humans; D008545:Melanoma / Q000209:etiology*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology*; D055108:Sunbathing
keywords: Norway; cohort studies; indoor tanning; melanoma; prospective studies; tanning beds; ultraviolet radiation