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Dr. Len's Cancer Blog

The American Cancer Society

Indoor Tanning: What We Say And What (Don't) Do

by Dr. Len December 10, 2008

So what if you knew about something that when used as intended caused harm, and your state’s regulations directed at that behavior were not enforced?  I bet you would be asking some questions, wouldn’t you?


In this case, we aren’t talking about cigarettes (although the comments above do apply in some jurisdictions around the country).  We are talking about indoor tanning.


The World Health Organization and the International Commission on Non-Ionizing Radiation Protection both recommend that children under the age of 18 years not be allowed to use indoor tanning, much less use it with the permission of a parent.


Why?  Because using a sun bed before the age of 35 is associated with a 75% increased risk of developing melanoma.  Indoor tanning is also associated with burns of the skin and eyes, alterations of the immune system, photo-aging of the skin, an increased risk of other skin cancers and causing adverse reactions to medications.


Two recent articles highlight the problems young people face in understanding the risks of indoor tanning, and what happens when states that have laws to restrict indoor tanning among youth are not enforced.


In the first article, recently published in the journal Cancer, colleagues of mine from the American Cancer Society reported on survey results comparing indoor tanning behavior of youths in 1998 and 2004.


They actually found that the use of indoor tanning hadn’t changed much over the six years.  In states that had put legislative restrictions in place, there was little change in tanning behavior.  However, in states that did not have such policies, indoor tanning increased.


What really made a difference in whether or not a young person frequented a tanning parlor was their own attitudes about tanning—namely, that they thought it made them look better and/or was associated with a health benefit—and if their parents signed the permission slip, which implied that the adults were not savvy on the risks of their child’s behavior.


Other factors that contributed to a higher use of indoor tanning included being a female and having a parent or guardian who used indoor tanning within the prior year.


How about this fact? Over one half (57.5%) of the children who used an indoor tanning booth or sunlamp suffered a skin burn.


So we know that indoor tanning harms people—especially young people—and yet they continue to do it (in the study, 17.7% of the girls in the 2004 survey used indoor tanning).


But don’t we have laws to regulate indoor tanning among youth? 


And that is the focus of the second article, which appeared in a journal published by the Centers for Disease Control, called “Preventing Chronic Disease: Public Health Research, Practice and Policy.”


In this study, the authors checked in on the largest cities in each of the 28 states that have some legislation regulating indoor tanning facilities.  I guess one shouldn’t be surprised at the results.


Less than half of the cities gave citations to facilities that violated state laws regarding indoor tanning.  1/3 of the cities didn’t even bother to do an inspection to check for violations of state laws.  Another 1/3 did inspections less than once a year.  The somewhat good news from the study was that in those cities where inspections were done, most were unannounced.


Akin to a state that passes a law against smoking in restaurants but doesn’t put into place an adequate enforcement mechanism, these laws regarding indoor tanning—especially those that protect our youth—are worthless if it is widely understood that the laws don’t have any teeth behind them.


So what are we left with?


First, we know that indoor tanning is harmful, especially among adolescents who shouldn’t be using tanning beds in the first place according to internationally recognized expert organizations.


Second, we know that some states feel better because they have passed laws to regulate indoor tanning.  But they should take scant comfort for the most part since the laws either are weakly enforced or aren’t enforced at all.


Third, and perhaps most important, we know that a significant number of children and their parents haven’t gotten the message that tanning beds cause all sorts of bad things to happen.


Like many people my age, we didn’t have sunscreens when we were young.  We got sunburns and “developed” our tans because we thought they made us look better.


Today, we have millions of skin cancers diagnosed every year, and recent reports show us that melanoma—a serious and potentially fatal form of skin cancer—are increasing rapidly (7.7% a year in men and 2.3% a year in women).


Maybe it’s time for us to take this threat just a bit more seriously.  Otherwise, one of the legacies we will leave for our kids may just be a boom time for the dermatologists and the cancer docs 30 or 40 years from now when those sweet young things become older adults and have their skin cancers and melanomas that need to be treated.


I for one don’t think that is a very pretty picture.  We can do better.

Filed Under:

Other cancers | Prevention

The Global Cancer Burden: We Can Do More

by Dr. Len December 09, 2008

Cancer is projected to become the leading cause of death worldwide in 2010.


That is a staggering piece of information and one that deserves our full attention.  It means that despite the progress we have made here in the United States and other developed countries in decreasing the burden from cancer, the rest of the world is far behind and is suffering the consequences.


Today, here at our National Home Office in Atlanta, the American Cancer Society is joining with the Lance Armstrong Foundation, Susan G. Komen for the Cure, and the International Agency for Research on Cancer to highlight the worldwide burden of cancer, and what must be done around the globe to stem this needless tide of despair and death.


In the last 30 years of the 20th century, the global burden of cancer has more than doubled.  That trend is projected to continue, and by 2030 there could be 27 million newly diagnosed cases of cancer, 17 million deaths each year and 75 million people alive with cancer within five years of diagnosis.


Why are we seeing this explosion in cancer?


One quarter of cancers in cancers in developing countries are attributable to infectious diseases, some of which are preventable with currently available vaccines.  More importantly, although 12% of cancers in developing countries today are related to tobacco, that number is expected to increase significantly as cigarettes spread their scourge around the world. There are many countries that are still in the relatively early stages of their own tobacco pandemics, and have yet to be impacted to the degree seen in the United States.  The future devastation from tobacco on the health of those countries is absolutely frightening.


Another sad tale is that many developing countries are adopting Western lifestyles at a quickening pace.  We are exporting our diets, our habits and our fast-food outlets throughout the world.  Along with that comes overweight and obesity, and with that an increase in the risk of cancer deaths in both men and women.


Couple these factors with an increase in global population and aging of that population, and you have a formula guaranteed to increase the numbers of people diagnosed and dying from cancer.


The organizations coming together here today have issued a “call to action” that they believe will help stem the tide of this developing tsunami:


1) Make vaccines that prevent infections which cause cancer more widely available to low-income nations. 


This is especially needed for cervical cancer, which is a leading cause of cancer death among women in low-income nations.  Unfortunately, this vaccine is expensive, and we need to find ways to make it more affordable so women in developing countries can have access.


2) Commit to a comprehensive tobacco control approach in the United States. 


We are making progress, but we could do better.  The recently released “Report to the Nation” highlighted the wide disparities among states when it comes to effective tobacco control measures.  The natural result is that there are parts of this country—including many in the Southeast—where deaths from tobacco-related cancers far exceed those in other parts of the country.  This is not a distinction we should be proud of.


3) Ratify the Framework Convention on Tobacco Control here in the United States. 


161 countries throughout the world have ratified this treaty which is designed to reduce the devastating health and economic burdens of tobacco.  Why not us?


4) Support Non-Governmental Organizations’ (NGOs) efforts to build advocacy and resources, empower survivors, and reduce suffering throughout the world. 


We have learned here in the United States and elsewhere that power comes from within.  We need to take the lessons we have learned, and help others to help themselves in a manner consistent with their own cultures.  We need to encourage governments and companies throughout the world to recognize that they have the ability to influence the cancer burden in their own countries.  They are far from powerless if they decide to address the issues.


5) Promote culturally sensitive risk reduction and education campaigns. 


People throughout the world can get the message, and they can do something to help control their fate.  We have believed, and we have accomplished.  So can people everywhere, through advocacy and raising awareness among the public, governments, civil society and the private sector.


6) Invest in cancer research and expand access to prevention and early detection measures. 


Infrastructure is a “hot topic” these days.  There is a cancer research infrastructure as well, and that infrastructure is at risk of decaying because of research funding that has been flat or cut.  We also need to make certain that every person in this country has access to prevention, early detection and effective treatment for cancer.  Now is the time to make certain that everyone can get access to what we already know works.  The impact would be astounding.


So, as we gather here in Atlanta this morning, the message will be one of alarm and concern.  But it will also be one of hope.


We have accomplished a great deal in this country attacking the burden of cancer.  We could do much more.  We can also work with our colleagues around the globe to empower people and nations to understand that they too can do more. 


They can do more to prevent cancer, especially through controlling the tobacco epidemic before it grips their nations.  They can do more to get cancer-preventing vaccines to their people who are suffering the impact of cancers that we in the United States and other developed nations have done much to prevent and control.  And they can get the attention of their governments and their corporations in this increasingly flattening world to pay attention to the human “bottom line” as well as the financial bottom line.


Let’s hope that the power of these very special and committed organizations coming together in recognition of this global epidemic is the start of a special journey that we will look back on with pride in the years to come.

Filed Under:

Cancer Care | Tobacco | Vaccines

About Dr. Len

Dr. Len

J. Leonard Lichtenfeld, MD, MACP - Dr. Lichtenfeld is Deputy Chief Medical Officer for the national office of the American Cancer Society.