Ghiasvand Reza, Rueegg Corina S, Weiderpass Elisabete, Green Adele C, Lund Eiliv, Veierød Marit B
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.
Am J Epidemiol. 2017 Feb 1;185(3):147-156. doi: 10.1093/aje/kww148.
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.
室内晒黑与黑色素瘤风险增加有关，但大多数证据来自病例对照研究。利用挪威女性与癌症研究（一项大型前瞻性队列研究）的数据，我们调查了开始室内晒黑的年龄、使用晒黑设备的持续时间以及剂量反应与黑色素瘤风险之间的关联，并研究了室内晒黑在黑色素瘤诊断年龄方面的作用。我们使用泊松回归来估计室内晒黑与黑色素瘤风险关系的相对风险和95%置信区间，并使用线性回归来研究开始室内晒黑的年龄与诊断年龄之间的关系。在对141,045名女性进行随访期间（1991年至2012年；平均随访时间 = 13.7年），861名女性被诊断出患有黑色素瘤。黑色素瘤风险随着晒黑疗程累计次数的增加而增加（使用次数最高三分位数与从不使用相比，调整后的相对风险 = 1.32，95%置信区间 (CI)：1.08, 1.63）；P趋势 = 0.006。与从不使用相比，开始晒黑的年龄<30岁与更高的风险相关（调整后的相对风险 = 1.31，95% CI：1.07, 1.59）。此外，30岁之前开始室内晒黑的女性在诊断时平均比从不晒黑的女性年轻2.2岁（95% CI：0.9, 3.4）。这项队列研究提供了有力证据，证明室内晒黑与黑色素瘤风险之间存在剂量反应关联，并支持以下假设：年轻时更容易受到室内晒黑有害影响。
