Lazovich DeAnn, Isaksson Vogel Rachel, Weinstock Martin A, Nelson Heather H, Ahmed Rehana L, Berwick Marianne
Masonic Cancer Center, University of Minnesota, Minneapolis2Division of Epidemiology and Community Health, University of Minnesota, Minneapolis.
Masonic Cancer Center, University of Minnesota, Minneapolis.
JAMA Dermatol. 2016 Mar;152(3):268-75. doi: 10.1001/jamadermatol.2015.2938.
In the United States and Minnesota, melanoma incidence is rising more steeply among women than men younger than 50 years. To our knowledge, no study has examined age- and sex-specific associations between indoor tanning and melanoma to determine if these trends could be due to greater indoor tanning use among younger women.
To examine associations between indoor tanning and melanoma among men and women younger than 50 years.
DESIGN, SETTING, AND PARTICIPANTS: Population-based case-control study conducted in Minnesota of 681 patients (465 [68.3%] women) diagnosed as having melanoma between 2004 and 2007, and 654 controls (446 [68.2%] women), ages 25 to 49 years.
Indoor tanning, defined as any use, first age of use, and total sessions.
Crude and adjusted odds ratios (ORs) and 95% CIs were calculated for melanoma in relation to indoor tanning exposure for men and women by diagnosis or reference age (<30, 30-39, 40-49 years). Sex-specific associations for indoor tanning and melanoma by anatomic site were examined.
Compared with women aged 40 to 49 years, women younger than 40 years initiated indoor tanning at a younger age (16 vs 25 years, P < .001) and reported more frequent indoor tanning (median number of sessions, 100 vs 40, P < .001). Women younger than 30 years were 6 times more likely to be in the case than the control group if they tanned indoors (crude OR, 6.0; 95% CI, 1.3-28.5). Odds ratios were also significantly elevated among women, ages 30 to 49 years (adjusted OR, 3.5; 95% CI, 1.2-9.7 for women 30-39 years; adjusted OR, 2.3; 95% CI, 1.4-3.6 for women 40-49 years); a dose response was observed among women regardless of age. Among men, results by age were inconsistent. The strongest OR for indoor tanning by anatomic site was for melanomas arising on the trunk of women (adjusted OR, 3.7; 95% CI, 1.9-7.2).
Indoor tanning is a likely factor for the steeper increase in melanoma rates in the United States among younger women compared with men, given the timing of when women initiated indoor tanning relative to diagnosis. The melanoma epidemic can be expected to continue unless indoor tanning is restricted and reduced.
在美国和明尼苏达州，50岁以下女性的黑色素瘤发病率比男性上升得更为陡峭。据我们所知，尚无研究探讨室内晒黑与黑色素瘤之间按年龄和性别划分的关联，以确定这些趋势是否可能归因于年轻女性更多地使用室内晒黑。
研究50岁以下男性和女性中室内晒黑与黑色素瘤之间的关联。
设计、地点和参与者：在明尼苏达州进行的一项基于人群的病例对照研究，研究对象为2004年至2007年间被诊断患有黑色素瘤的681例患者（465例[68.3%]为女性）和654例对照（446例[68.2%]为女性），年龄在25至49岁之间。
室内晒黑，定义为任何使用情况、首次使用年龄和总疗程数。
计算黑色素瘤与室内晒黑暴露相关的粗比值比（OR）和调整后比值比以及95%置信区间（CI），按诊断或参照年龄（<30岁、30 - 39岁、40 - 49岁）对男性和女性进行分析。研究了按解剖部位划分的室内晒黑与黑色素瘤的性别特异性关联。
与40至49岁的女性相比，40岁以下的女性开始室内晒黑的年龄更小（16岁对25岁，P < 0.001），且报告的室内晒黑频率更高（疗程数中位数，100次对40次，P < 0.001）。30岁以下的女性如果进行室内晒黑，其病例组比对照组的可能性高6倍（粗OR，6.0；95% CI，1.3 - 28.5）。30至49岁女性的比值比也显著升高（30 - 39岁女性调整后OR，3.5；95% CI，1.2 - 9.7；40 - 49岁女性调整后OR，2.3；95% CI，1.4 - 3.6）；无论年龄大小，女性中均观察到剂量反应。在男性中，按年龄划分的结果不一致。按解剖部位划分，室内晒黑与黑色素瘤关联最强的是女性躯干上发生的黑色素瘤（调整后OR，3.7；95% CI，1.9 - 7.2）。
鉴于女性开始室内晒黑的时间与诊断时间的关系，室内晒黑可能是美国年轻女性黑色素瘤发病率比男性上升更陡峭的一个因素。除非限制和减少室内晒黑，否则黑色素瘤的流行可能会持续。
