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They say Sunbeds cause skin cancer BUT - is this really the case? All is not it appears to be as the latest study shows....

T200 Tower SunbedIt is a widely held belief that the use of sunbeds increases the risk of developing skin cancer. But now a large-scale study carried out by the University of Leeds in the UK is showing how the opposite is in fact true.

Over the years, various groups of researchers have tried in vain to establish a link between the use of sunbeds and the spread of dangerous malignant melanoma and the media have always been more than willing to add more fuel to the fires of anxiety engendered by this topic. However, we often forget that UV exposure is crucial if the body is to maintain an adequate level of vitamin D, which in turn has a positive effect on the entire immune system.

Led by Faye Elliot, a high-level team of scientists from the University of Leeds has spent years researching the link between UV radiation and malignant melanoma. The team carried out a study involving around 1,000 participants, aged between 16 and 76, who had all been diagnosed with malignant melanoma. The results were then compared with those of a healthy control group. In addition to a wide range of information such as skin type and family predisposition, all study participants were asked when they first used a sunbed, how often they use sunbeds and how long they spend in the sun.

The study showed NO evidence of a link between sunbed use and an elevated risk of skin cancer. It is also interesting that the study was held in the UK, where a very large number of people are skin type 1, with the correspondingly high risk of developing skin cancer.

Sunlight Research FoundationWhen it comes to UV exposure - whether from the sun or a sunbed - it's all a question of how much. "In today's competitive society, where people spend more time at their desks than outside in the fresh air, moderate exposure to sunlight from sunbeds can help to boost vitamin D levels. This is particularly helpful during those months when there is very little natural sunlight around, in other words between September to April", Ad Brand of the Sunlight Research Forum (SRF) explains.


Relationship between Sunbed Use and Melanoma Risk in a Large Case-Control Study in the United Kingdom
International Journal of Cancer

A systematic review of 19 studies reported a 15% increased risk of melanoma (95% confidence interval (CI) 1.00-1.31) associated with ever use of sunbeds 1.

A recent Australian study by Cust et al demonstrated an increased risk of early-onset melanoma (<40 years) associated with ever use of sunbeds (adjusted odds ratio (OR) 1.41, 95%CI 1.01-1.96).  Concurrently with the Australian study and using the same questionnaire we investigated the relationship between sunbed use and melanoma at any age in the United Kingdom.

A similar estimate in the UK, which has higher sunbed usage, would imply that unbed usage is a major etiological factor for melanoma.

Nine hundred and fifty-nine population-ascertained incident melanoma cases diagnosed September 2000-December 2005 (age 17-76 years at diagnosis, 22% <40 years at diagnosis), 513 population-ascertained controls and 174 sibling controls were recruited to a case-control study whereby comprehensive sun exposure data, including a life-long residence calendar, were collected as described previously. Participants were asked about sunbed or sunlamp use (ever versus never) and about locations they were used.

Data were collected on age at first and last use and number of lifetime sessions. Years since first use was calculated and these variables were categorized as presented by Cust et al: never, <25 , ≥25 years; none, 1-10, >10 sessions; never, ≤4, >4 & ≤14, >14 years respectively.

A proxy for sun sensitivity phenotype (categorized as sun-sensitive or not sun-sensitive) was derived, as described previously.

As far as possible, we repeated the analyses as reported by Cust et al. In our case-control study we found the sun exposure measure most associated with risk was a protective effect of regular weekend sun exposure.

We therefore repeated the analyses adjusting for this measure but there was no effect on the results.

The locations where sunbeds were used were private home (54%), tanning salons (34%), gyms/spas (32%), hairdressers/beauty salons (13%) and hospital/medical facilities (9%).
Sun sensitivity phenotype and educational level were not associated with sunbed use.

Therefore, we have not found any evidence of a relationship between sunbed use and melanoma risk (OR 1.06, 95%CI 0.83-1.36 for ever use).

Cust et al reported an effect of ever use on early-onset melanomas (OR 1.41, 95%CI 1.01-1.96).
A test for the difference between the two ORs was not statistically significant (p=0.18).

Cust et al reported a stronger effect for age at first sunbed use <25 years, however our study was underpowered to address these specific relationships.

Our study had 85% power to detect an OR of 1.4 (assuming a binary factor with exposure frequency of 45% amongst controls, 5% significance level) but was underpowered to detect small effects.

Two UK studies conducted more than 20 years ago reported significant increased risks for ever sunbed use with relative risks of 2.9 in both studies4, 5.

Three more recent UK studies demonstrated small non-significant increased risks for ever use6-8.
Our study has a similar finding which could indicate an effect of sunbeds, but could also be due to confounding with other UV exposures.

In summary, we have found no evidence for sunbed use as a risk factor for melanoma in the UK; although we cannot exclude a small effect of ever sunbed use, nor risk associated with use early in life, we can exclude a large effect.


International Journal of Cancer
Relationship between Sunbed Use and Melanoma Risk in a Large Case-Control Study in the United Kingdom
Faye Elliott1, Mariano Suppa1,2, May Chan1, Susan Leake1, Birute Karpavicius1, Sue Haynes1, Jennifer H Barrett1, D Timothy Bishop1 and Julia A Newton-Bishop1
1 Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine,
University of Leeds, Leeds, UK
2 Department of Dermatology, University of L'Aquila, L'Aquila, Italy

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