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Second Primary Melanomas: Increased Risk and Decreased Time to Presentation in Patients Exposed to Tanning Beds
TAKE-HOME MESSAGE
- This retrospective study determined if certain characteristics distinguish patients who developed melanoma following artificial UV radiation (arUVR). At any age, patients with multiple primary melanomas had a higher probability of exposure to arUVR. Approximately 65% of patients exposed to arUVR tanning beds were diagnosed with a second primary melanoma within 1 year of the first diagnosis, compared with 28% of non-tanners (P=.011). The median time to diagnosis of second primary melanoma in tanners vs non-tanners was 225 days vs 3.5 years, respectively.
- The modifiable risk factors for melanoma include UV radiation from the sun or from the tanning beds. Patients who used tanning beds had a significantly earlier diagnosis of second primary melanoma, suggesting that heightened surveillance in melanoma patients exposed to arUVR is needed.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND
Melanoma incidence has increased; the primary modifiable risk factor is ultraviolet radiation (UVR) from the sun or artificial UVR (arUVR) from tanning beds.
OBJECTIVE
To determine whether patients who developed melanoma after arUVR exposure from tanning beds have unique characteristics.
METHODS
A retrospective study of 434 melanoma patients was performed. Patients who consented at the initial appointment completed a questionnaire regarding phenotypic traits, medical history, and UVR exposure.
RESULTS
Compared with patients aged ≥40 years, younger patients, especially women, had greater lifetime exposure to arUVR. At any age, patients with multiple primary melanomas had a higher probability of exposure to arUVR. For all patients with additional primary melanomas, those exposed to arUVR acquired their second primary melanoma significantly earlier; 67% of patients exposed to arUVR through tanning beds had their second primary diagnosed at the time of or within 1 year of their original diagnosis compared with 28% of nontanners (P = .011). Median time to diagnosis of second primary melanoma in patients exposed to arUVR versus those not exposed was 225 days versus 3.5 years, respectively (P = .027).
LIMITATIONS
The study was conducted in 1 geographic area with a relatively small sample size.
CONCLUSION
Our findings provide evidence for heightened surveillance in melanoma patients exposed to arUVR.
Additional Info
Second Primary Melanomas: Increased Risk and Decreased Time to Presentation in Patients Exposed to Tanning Beds
J Am Acad Dermatol 2018 Oct 19;[EPub Ahead of Print], Y Li, M Kulkarni, K Trinkaus, LA CorneliusFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Dermatologists are well aware of the risks of indoor tanning and the increased risk of melanoma. Although that risk applies to everyone, fair women under age 40 with a history of indoor tanning should be given extra caution and increased surveillance, not only to catch their first possible melanoma, but with even more heightened surveillance within the following year for formation of their second primary melanoma. Furthermore, much like smoking cessation education has been integral in public health for lung cancer prevention and other pulmonary morbidities, indoor tanning education, particularly in young teenaged women and those in their 20s, should be aggressively pursued in both public health and in all of our offices. In my practice, yearly skin exams are recommended for anyone without a history of any skin cancer. It may be worthwhile to make a slight change to perhaps identify young women with indoor tanning usage for semi-annual skin exams, in addition to more aggressive patient education.