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BCC Study Does Not Implicate
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Thursday, December 15th, 2011

A study promoted to the North American media Tuesday ahead of its actual publication on-line in the Journal of the American Academy of Dermatology should not be applied to professional tanning facilities, but more likely to severe sunburns from unsupervised usage of home tanning units — the third time in a decade that the dermatology community has failed to accurately report this important confounder in promoting a study.

That’s an important failure — because the body of work on this topic to date has not supported a statistically significant connection between indoor tanning and basal cell carcinoma, a local form of skin cancer especially common in older men that almost never spreads unless an elderly person’s immune system has been compromised. The World Health Organization, in a review of skin cancer research in 2006, failed to find a connection between indoor tanning usage and basal cell carcinoma in reviewing all of the studies to date — a meta-analysis of four other studies on this topic. The U.S. Preventative Services Task Force, in looking at the issue this year, also could not find a supportable link between sunbed usage and BCC.

The American Academy of Dermatology did not allow access to the full study protocol ahead of national promotion of this study this week, but it appears likely from their abstract description of the study that intermittent sunburns from unsupervised home unit usage — and not commercial salons — were implicated.

That would make the third time dermatology lobbying groups have made that mistake since 2002. A 2002 non-peer-reviewed paper from Dartmouth University researchers attempted to suggest that tanning salon usage was related to basal cell carcinoma. But most of the subjects in that paper started using sunlamps before 1975 — well before indoor tanning salons even existed — which the researchers did not discuss in their report.

In 2009 a World Health Organization working group attempted to suggest in a review article that tanning salon usage was associated with melanoma skin cancer, but failed to identify that their data set implicated home sunbed usage and medical use of sunbeds, but that professional salon usage had no statistically significant association.

“Dermatology still uses sunbeds to intentionally sunburn patients with the cosmetic skin disease psoriasis,” Smart Tan Vice President Joseph Levy said. “At the same time they are claiming they do not increase risk with their usage of sunbeds at $100 a session billed to insurance companies, they are alleging that professional salons that use less-dosage and do not intentionally sunburn clients are a risk factor. That does not make any sense at all.”

The study authors admit that the overwhelming majority — 73 percent of early-onset BCC cases — were not related to sunbed usage. “This paper, and the way it was distributed, appear politically motivated, not scientifically objective,” Levy said.

Basal cell carcinoma is a form of skin cancer common in older men and is believed to be associated with intermittent sunburn episodes, smoking and a high-fat diet. According to the American Cancer Society, it almost never spreads unless an individual is undergoing chemotherapy or has some other condition that compromises his/her immune system.

Professional indoor tanning facilities practice and teach sunburn prevention.

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