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The Summer Sun Is Soon Upon Us: Bring Back the Fedora

May 23, 2013

Skin cancer affects people of all ages and races, and it most often develops on the areas of a person’s skin most exposed to the sun—exposure to ultraviolet (UV) radiation and a history of sunburn are risk factors. According to the American Cancer Society, there are about 3.5 million diagnoses annually of skin cancer, more than the new diagnoses of breast, prostate, lung, and colon cancers combined.

Paul B - Sun Protection

Photo courtesy of Paul B

It is estimated that one in five Americans will develop skin cancer in their lifetime, yet it is chiefly a lifestyle disease, and is preventable. In addition to the usual precautions when outdoors, a really good idea is to stay away from indoor tanning salons.

Two articles on the dangers of indoor tanning appear in the current issue of the Journal. The first, Preventing Skin Cancer Through Reduction of Indoor Tanning: Current Evidence, provides a brief review of the evidence linking indoor tanning to skin cancer, why people use indoor tanning devices, and things to consider when developing strategies to reduce indoor tanning. This information sets the context and background for the companion paper in this issue, Strategies to Reduce Indoor Tanning: Current Research Gaps and Future Opportunities for Prevention,  which

summarizes highlights from a meeting of experts convened by the CDC in August 2012 to explore ways to reduce the use of indoor tanning devices.

The August meeting at the CDC came hard on the heels of their May morbidity report, Sunburn and sun protective behaviors among adults aged 18-29 years—United States, 2000-2010.

The CDC report found that although some sun protective behaviors, including shade and sunscreen use and wearing long clothing to the ankles, have increased in recent years among adults, the prevalence of sunburn in 2010 remained high (50.1%), especially among whites (65.6%). Previous data have indicated that most U.S. adults aged 18–29 years do not regularly engage in protective behaviors when outdoors in the sun, and approximately half have experienced sunburn in the past year.

The implications for public health practice are that provision of shade and sunscreen in recreational settings and clinical counseling of younger adults are promising strategies for creating environments and social norms that facilitate sun protection and sunburn prevention in this population.

Recent recommendations from the International Agency for Research on Cancer, a subsidiary of the World Health Organization, state, “Policymakers should consider enacting measures, such as prohibiting minors and discouraging young adults from using indoor tanning facilities, to protect the general population from possible additional risk for melanoma.”

The American Academy of Dermatology Association, Environmental Protection Agency, Food and Drug Administration, Indoor Tanning Association, National Cancer Institute, and the National Council on Skin Cancer Prevention, have each made recommendations regarding the use of tanning devices—from requiring parental consent for minors to banning all use by children under age 18.

Currently California and Vermont ban the use of tanning beds for all minors under 18, and at least 33 states regulate the use of tanning facilities by minors. Eighteen states require operators to limit exposure time to manufacturers’ recommendations and provide eye protection. Along with requiring parental permission for minors, Arizona also requires public schools to provide education about risks to developing skin cancer. For a list of current laws see, Indoor Tanning Restrictions for Minors: A State-by-State Comparison, compiled by the National Conference of State Legislatures.

Fortunately, there are some easy tips to help prevent skin cancer. The Mayo Clinic has a new public service announcement airing this month that offers the following tips:

  • use sunscreen
  • skip tanning beds
  • seek shade
  • get spots checked.

I’d also like to see fedoras back in style, and swank supper clubs where we can stay out of the sun.

—Michael Lytton, AJPM Blog Editor

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