Incredulous. Astounding. Unanticipated.
Those were my initial thoughts when I had a moment to read the two reports released yesterday by the Centers for Disease Control and Prevention about the use of tanning beds and sunburn/sun protective behaviors.
I was completely unprepared for the results of the studies. And I am supposed to know this stuff.
As I mentioned in one of the interviews published on the topic, the information contained in those studies raised my concern and passion about the topic to a new level. And if you are aware of this issue, it should raise your concerns as well. If the trends on tanning bed use and failure to engage in sun safe behaviors continue, we could be in for a serious problem regarding skin cancer and melanoma in years to come.
Now we have information from the CDC that the situation is worse than many of us thought.
First, some of the numbers:
- 31.8% of white women between the ages of 18 and 25 used tanning beds in the 12 months prior to the survey, which was conducted in 2010. For white women between the ages of 22-25 the use was 29.6%.
- Among white adults who engaged in indoor tanning, the experts tell us that 57.7% of the women and 40% of the men used tanning beds more than 10 times in the prior 12 months.
- Amazingly, 9% of adults (that's everyone, folks--not just whites) with a family history of skin cancer used a tanning bed in the prior 12 months.
- 44% of white women between 18 and 21 in the Midwest--that's almost half of that population--used a tanning bed, while in the South for women between 22 and 25 years of age, 36.4% had tanning bed exposures.
- For women of all adult ages who used a tanning bed, the AVERAGE use was 20.3 sessions a year. Among young women between 18 and 21 years, the average number of sessions for those who used tanning beds was an astounding 27.6 sessions a year.
Among measures designed to look at the use of sunscreens and sun safe behaviors, the numbers were equally discouraging.
- About 1 out of 3 women used sunscreen or stayed in the shade as the most common sun safe behavior. Other recommended strategies such was wearing a wide brimmed hat or a long sleeve shirt were way behind.
- Men were behind in the sunscreen category, with only 15.6% used sunscreen, while 32.9% wore long clothing to the ankles and 25.6% stayed in the shade.
- To me, the most important statistic in this report was the incidence of sunburn in white adults. After all, that is the ultimate measure of success: less sunburn, more success in reducing risk of skin cancer; more sunburn, the odds go up. The number? 65.6%--almost 2 out of every 3 adult whites in the United States--had a sunburn in 2010.
And if people who have a family history of skin cancer--who you would think are most sensitive to the issue and should be aware of the risks--think it's OK to use a tanning bed, then we have seriously failed in getting our message out to the population at large.
Why all the concern?
Studies are showing us that exposure to tanning beds and repeated sunburns--especially early in life--lead to increase risk of skin cancer and melanoma later in life. Tanning beds give concentrated doses of UVA and UVB compared to natural sun light, increasing that risk.
The researchers note what we are seeing in our data:
"Melanoma incidence rates are increasing and are higher among young white women than among young white men, which might be attributable, in part, to their increased rates of indoor tanning. Indoor tanning is particularly dangerous for younger users because indoor tanning before age 35 years increases the risk for melanoma."
Let me try to give you some perspective:
We have a number of instances where we have ignored early warning signs of coming cancer epidemics. Early investigations of the links between asbestos exposure and mesothelioma and tobacco and lung cancer are but two examples to make the point. By the time much of the damage was done, it was too late for too many. The lesson learned is that when you start to see the early warning signs of an increasing rate of cancer and a causal event, you need to take the situation seriously.
Unlike cell phones, where there remains considerable debate and no clear increase in the incidence of brain cancers (the experts as you may be aware debate this regularly) the increased incidence of melanoma among young white women provides a clear early warning signal that with respect to tanning beds, we have a problem on our hands. And the risk is that if we don't take this message seriously, many lives are going to be impacted over decades because of tanning beds and the failure to take safe sun behavior seriously.
That's why the numbers above are so disconcerting. That's why I am very concerned about the segment the Today Show had last week on tanning beds where they had the svelte spokesman and handsome model demonstrate tanning on live TV. Nancy Snyderman did a yeoman job trying to tell the real truth about "sunless tanning", while Mr. Spokesman made the comment that sunlight is just like water--we all need it. The difference is that the sunlight from that tanning bed and repeated sunburns can cause many problems that--for the most part in this country--water does not.
In case you don't get the message, the tanning bed industry is very clever in making you believe or want to believe that their product is safe when used as intended. Well, it's not. The research says it's not, and the International Agency on Research in Cancer says it's not. In fact they say it is a class I carcinogen. It is the "whole enchilada, no questions asked": tanning beds cause cancer. And with so many people getting tanning bed exposure, there is the potential that these machines have the potential to cause an unnecessary number of cancers, not to mention needless heartache for the patients and their families who have to deal with the unfortunate effects of their behaviors.
Where do we go from here?
I would like to believe that our efforts to inform people of the risks of indoor tanning and not engaging in sun safe behaviors have had meaningful results. Unfortunately, if we are going to be honest with each other, it appears we have not been as successful as we would like. We can and should do better.
One of those approaches is to increase advocacy efforts to reduce the risk of tanning bed exposures in young folks. That's where much of the action is currently, and if the numbers in these studies are any reflection of the situation around the United States, then relief cannot come too soon. As recently confirmed in a report from the House Energy and Commerce Committee, these tanning salons--which Mr. Spokesman on the Today Show said were well controlled by the owners--are in fact out of control.
The new regulations from the Food and Drug Administration on sunscreen labeling may have an impact on more appropriate use of sunscreens and sun safe behaviors. But educationally, we have a long way to go to improve our messaging on how to properly use sunscreens and engage in activities to reduce your risk of sunburn and subsequent skin cancers.
So, yes, I am astonished and amazed. And I hope you are as well.
Sometimes the facts aren't pretty, and this is one of those times. It is incumbent on all of us--whether it be through advocacy, education or personal behaviors--to do what we can do to positively impact this situation. If we don't , there is the real possibility that some folks are going to pay with their lives, and that is not acceptable given what we know today.
These reports suggest that we need to act now. As we learned from the tobacco debacle, "woulda, coulda, shoulda" just doesn't cut it.