By Kathryn Doyle
NEW YORK (Reuters Health) - One in seven people goes back to a tanning bed after being diagnosed with skin cancer, according to a new research letter.
Indoor tanning is known to increase a person's risk for cancer.
"The situation may be analogous to that of lung cancer patients who continue to smoke after diagnosis," said lead author Brenda Cartmel, a cancer prevention researcher at the Yale School of Public Health in New Haven, Connecticut.
"Just as tobacco is known to be addictive, our research suggests that some patients may become dependent on tanning, with new intervention approaches needed to change these behaviors," she told Reuters Health.
Most of the 20 million people who use tanning beds in the U.S. each year are young white women. The beds emit up to 15 times the ultraviolet A (UVA) radiation of the sun. That type of radiation damages deep layers of skin.
The new study included people who had been diagnosed with basal cell carcinoma - a slow-growing skin cancer which can be removed but increases the risk for subsequent skin cancers - before age 40.
Basal cell carcinoma is the most common type of cancer in the U.S., and occurs most often among men over the age of 50. But other studies have found an increased number of those cancers among young women in the last 30 years, which inspired the current investigation, Cartmel said.
She and her coauthors surveyed white patients in Connecticut who had participated in a study of basal cell carcinoma one to four years earlier. The researchers included results from the 178 people who had tanned indoors before being diagnosed.
Of them, 26 - about 15 percent - said they had tanned indoors again at least once over the past year, with some visiting the booth up to 20 times, according to findings published in JAMA Dermatology. Those people reported tanning more often before their diagnosis than the rest of the group.
More than half of the still-tanners reported symptoms of dependence, such as feeling guilty about tanning or needing to tan first thing in the morning, compared to 36 percent of those who had quit tanning.
"This is not surprising at all," said Dr. Steven Feldman, a dermatologist at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.
There's a lot of evidence that UV light exposure can be addictive, he told Reuters Health.
"If you take skin cells in culture and expose them to UV light, they make endorphins, those feel-good molecules," he said.
Like nicotine, Feldman said, tanning has social pressures at work but can also be physically addictive. But unlike cigarette smoke, which has been banned in many public places, indoor tanning only harms the individual who gets in the booth. There's no such thing as "secondhand tan."
Banning or taxing tanning booths would reduce basal cell carcinomas, but whether the government should take that step is up for debate, said Feldman, who was not involved in the new study.
For his older patients who are diagnosed with skin cancer, he recommends wearing a hat and gives them catalogs of sun-protective clothing.
With young people, it may be a good idea to remind them not to tan indoors, he said.
"For the typical patient who gets diagnosed, though, we don't need to tell them," Feldman said.
SOURCE: http://bit.ly/12reDen JAMA Dermatology, online July 3, 2013.