Second primary melanomas: Increased risk and decreased time to presentation in patients exposed to tanning beds

J Am Acad Dermatol. 2018 Dec;79(6):1101-1108. doi: 10.1016/j.jaad.2018.06.067. Epub 2018 Oct 19.

Abstract

Background: Melanoma incidence has increased; the primary modifiable risk factor is ultraviolet radiation (UVR) from the sun or artificial UVR (arUVR) from tanning beds.

Objective: To determine whether patients who developed melanoma after arUVR exposure from tanning beds have unique characteristics.

Methods: A retrospective study of 434 melanoma patients was performed. Patients who consented at the initial appointment completed a questionnaire regarding phenotypic traits, medical history, and UVR exposure.

Results: Compared with patients aged ≥40 years, younger patients, especially women, had greater lifetime exposure to arUVR. At any age, patients with multiple primary melanomas had a higher probability of exposure to arUVR. For all patients with additional primary melanomas, those exposed to arUVR acquired their second primary melanoma significantly earlier; 67% of patients exposed to arUVR through tanning beds had their second primary diagnosed at the time of or within 1 year of their original diagnosis compared with 28% of nontanners (P = .011). Median time to diagnosis of second primary melanoma in patients exposed to arUVR versus those not exposed was 225 days versus 3.5 years, respectively (P = .027).

Limitations: The study was conducted in 1 geographic area with a relatively small sample size.

Conclusion: Our findings provide evidence for heightened surveillance in melanoma patients exposed to arUVR.

Keywords: melanoma; tanning beds; ultraviolet radiation.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cosmetic Techniques / adverse effects*
  • Cosmetic Techniques / instrumentation
  • Disease Susceptibility
  • Ethnicity
  • Female
  • Hair Color
  • Humans
  • Male
  • Melanoma / epidemiology
  • Melanoma / etiology*
  • Middle Aged
  • Neoplasms, Radiation-Induced / epidemiology
  • Neoplasms, Radiation-Induced / etiology*
  • Neoplasms, Second Primary / epidemiology
  • Neoplasms, Second Primary / etiology*
  • Radiation Exposure
  • Registries
  • Retrospective Studies
  • Risk
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / etiology*
  • Skin Pigmentation
  • Sunburn / epidemiology
  • Sunscreening Agents
  • Time Factors
  • Ultraviolet Rays / adverse effects*
  • Washington / epidemiology
  • Young Adult

Substances

  • Sunscreening Agents