Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Institute of Health and Biomedical Innovation, Queensland University of Technology School of Nursing, Brisbane, Queensland, Australia.
JAMA Dermatol. 2020 Apr 1;156(4):401-410. doi: 10.1001/jamadermatol.2020.0001.
UV radiation emissions from indoor tanning devices are carcinogenic. Regulatory actions may be associated with reduced exposure of UV radiation at a population level.
To estimate the long-term health and economic consequences of banning indoor tanning devices or prohibiting their use by minors only in North America and Europe compared with ongoing current levels of use.
DESIGN, SETTING, AND PARTICIPANTS: This economic analysis modeled data for individuals 12 to 35 years old in North America and Europe, who commonly engage in indoor tanning. A Markov cohort model was used with outcomes projected during the cohort's remaining life-years. Models were populated by extracting data from high-quality systematic reviews and meta-analyses, epidemiologic reports, and cancer registrations.
Main outcomes were numbers of melanomas and deaths from melanoma, numbers of keratinocyte carcinomas, life-years, and health care and productivity costs. Extensive sensitivity analyses were performed to assess the stability of results.
In an estimated population of 110 932 523 in the United States and Canada and 141 970 492 in Europe, for the next generation of youths and young adults during their remaining lifespans, regulatory actions that ban indoor tanning devices could be expected to gain 423 000 life-years, avert 240 000 melanomas (-8.2%), and avert 7.3 million keratinocyte carcinomas (-7.8%) in North America and gain 460 000 life-years, avert 204 000 melanomas (-4.9%), and avert 2.4 million keratinocyte carcinomas (-4.4%) in Europe compared with ongoing current levels of use. Economic cost savings of US $31.1 billion in North America and €21.1 billion (US $15.9 billion) in Europe could occur. Skin cancers averted and cost savings after prohibiting indoor tanning by minors may be associated with one-third of the corresponding benefits of a total ban.
Banning indoor tanning may be associated with reduced skin cancer burden and health care costs. Corresponding gains from prohibiting indoor tanning by minors only may be smaller.
室内晒黑设备发出的紫外线辐射具有致癌性。监管行动可能与人群中紫外线辐射暴露的减少有关。
与当前的使用水平相比，估计在北美和欧洲禁止室内晒黑设备或仅禁止未成年人使用室内晒黑设备对长期健康和经济后果的影响。
设计、设置和参与者：这项经济分析对北美和欧洲 12 至 35 岁经常进行室内晒黑的个体进行了建模。使用马尔可夫队列模型对队列剩余寿命期间的结果进行预测。模型通过从高质量的系统评价和荟萃分析、流行病学报告和癌症登记处提取数据进行填充。
主要结果是黑色素瘤和黑色素瘤死亡人数、角质细胞癌数量、寿命以及医疗保健和生产力成本。进行了广泛的敏感性分析以评估结果的稳定性。
在美国和加拿大的估计人口为 110932523 人，在欧洲的估计人口为 141970492 人，对于下一代年轻人和年轻人，在他们的剩余寿命期间，禁止室内晒黑设备的监管行动预计将获得 423000 个寿命年，避免 240000 例黑色素瘤（-8.2%）和避免 730 万例角质细胞癌（-7.8%）在美国，获得 460000 个寿命年，避免 204000 例黑色素瘤（-4.9%）和避免 240 万例角质细胞癌（-4.4%）在欧洲，与当前的使用水平相比。在北美可能会节省 311 亿美元的经济成本，在欧洲可能会节省 211 亿欧元（159 亿美元）。禁止未成年人进行室内晒黑后可避免皮肤癌和节省医疗保健费用，可能仅占全面禁止室内晒黑的三分之一。
禁止室内晒黑可能与减少皮肤癌负担和医疗保健成本有关。仅禁止未成年人进行室内晒黑的相应收益可能较小。
