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Am J Epidemiol. 2017 Feb 1;185(3):147-156. doi: 10.1093/aje/kww148.

Indoor Tanning and Melanoma Risk: Long-Term Evidence From a Prospective Population-Based Cohort Study.

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Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Blindern,Oslo, Norway.
Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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.
Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway.


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.


Norway; cohort studies; indoor tanning; melanoma; prospective studies; tanning beds; ultraviolet radiation

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