Dodds Melissa, Arron Sarah T, Linos Eleni, Polcari Ingrid, Mansh Matthew D
Department of Dermatology, University of Minnesota, Minneapolis.
Department of Dermatology, University of California, San Francisco.
JAMA Dermatol. 2018 Sep 1;154(9):1066-1071. doi: 10.1001/jamadermatol.2018.2054.
Incidence rates of nonmelanoma and melanoma skin cancers are increasing rapidly in the United States likely because of increased UV light exposure. Sunless tanning is a safe alternative to achieve tanned skin that might help reduce skin cancer incidence by deterring risky behaviors. However, limited data exist on the characteristics and associated skin cancer risk behaviors of sunless tanners in the United States.
To assess the demographic characteristics and skin cancer risk behaviors of sunless tanners among adults in the United States.
DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of a cross-sectional study used data from the 2015 National Health Interview Survey, a population-based survey of the US noninstitutionalized civilian population. Participants included 27 353 men and women 18 years or older.
Participant demographics and skin cancer risk behaviors, including indoor tanning, skin cancer screening, sunburn, and sun protection behaviors.
Of the 27 353 adults (representative of more than 198 million US adults; mean [SE] age, 46.0 [0.2] years) studied, 6.4% (SE, 0.2%) reported sunless tanning. Factors associated with sunless tanning included being young, female, non-Hispanic white, college educated, nonobese, and sun sensitive, living in the western United States, and having a family history of skin cancer. Sunless tanners were more likely to report indoor tanning (adjusted prevalence odds ratio [aPOR], 3.77; 95% CI, 3.19-4.43; P < .001), recent sunburn (aPOR, 1.55; 95% CI, 1.31-1.83; P < .001), use of sunscreen (β = 0.19; 95% CI, 0.09-0.28; P < .001), and having had a full-body skin examination (aPOR, 1.77; 95% CI, 1.51-2.08; P < .001) but less likely to seek shade (β = -0.12; 95% CI, -0.19 to -0.04; P = .001) or use protective clothing when outdoors (long pants: β = -0.18; 95% CI, -0.26 to -0.11; P < .001; long sleeves: β = -0.10; 95% CI, -0.18 to -0.03; P = .01). Among indoor tanners, sunless tanners compared with those who did not sunless tan reported increased frequency of indoor tanning (mean [SE], 19.2 [1.9] vs 14.9 [1.2] sessions in the past 12 months; P = .04) but no differences in other skin cancer risk behaviors.
This study suggests that sunless tanning is associated with risky skin cancer-related behaviors. Longitudinal studies are needed to assess whether sunless tanning changes UV exposure behaviors to better determine whether sunless tanning represents an effective public health strategy to reduce rates of skin cancer in the United States.
在美国，非黑色素瘤和黑色素瘤皮肤癌的发病率正在迅速上升，这可能是由于紫外线暴露增加所致。日光浴是一种获得古铜色皮肤的安全替代方法，它可能通过阻止危险行为来帮助降低皮肤癌发病率。然而，关于美国日光浴者的特征以及与之相关的皮肤癌风险行为的数据有限。
评估美国成年人中日光浴者的人口统计学特征和皮肤癌风险行为。
设计、地点和参与者：这项横断面研究的二次分析使用了2015年美国国家健康访谈调查的数据，该调查是一项针对美国非机构化平民人口的基于人群的调查。参与者包括27353名18岁及以上的男性和女性。
参与者的人口统计学特征和皮肤癌风险行为，包括室内晒黑、皮肤癌筛查、晒伤和防晒行为。
在研究的27353名成年人（代表超过1.98亿美国成年人；平均[标准误]年龄为46.0[0.2]岁）中，6.4%（标准误，0.2%）报告有日光浴行为。与日光浴相关的因素包括年轻、女性、非西班牙裔白人、受过大学教育、非肥胖、对阳光敏感、居住在美国西部以及有皮肤癌家族史。日光浴者更有可能报告室内晒黑（调整后的患病率比值比[aPOR]，3.77；95%置信区间，3.19 - 4.43；P <.001）、近期晒伤（aPOR，1.55；95%置信区间，1.31 - 1.83；P <.001）、使用防晒霜（β = 0.19；95%置信区间，0.09 - 0.28；P <.001）以及进行过全身皮肤检查（aPOR，1.77；95%置信区间，1.51 - 2.08；P <.001），但不太可能寻找阴凉处（β = -0.12；95%置信区间，-0.19至-0.04；P =.001）或在户外时使用防护服（长裤：β = -0.18；95%置信区间，-0.26至-0.11；P <.001；长袖：β = -0.10；95%置信区间，-0.18至-0.03；P =.01）。在室内晒黑者中，与未进行日光浴的人相比，日光浴者报告的室内晒黑频率增加（过去12个月的平均[标准误]次数，19.2[1.9]次对14.9[1.2]次；P =.04），但在其他皮肤癌风险行为方面没有差异。
这项研究表明，日光浴与有风险的皮肤癌相关行为有关。需要进行纵向研究来评估日光浴是否会改变紫外线暴露行为，以便更好地确定日光浴是否代表一种有效的公共卫生策略来降低美国的皮肤癌发病率。
