(ChemotherapyAdvisor) – Data from the Nurses’ Health Study II (NHSII) cohort confirm a dose-response relationship between tanning bed use and risk of the three most common types of skin cancer, according to a study in the Journal of Clinical Oncology published online February 27.

The NHSII enrolled 116,678 US female registered nurses between the ages of 25 and 42 years in 1989. In this study, the authors investigated whether frequency of tanning bed use during high school/college or between the ages of 25 and 35 years was associated with risk of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma among 73,494 nurses, 5,506 of whom were diagnosed with BCC, 403 with SCC, and 349 with melanoma.

A dose-response effect was detected with use of tanning beds 4 times per year. Risk for BCC was increased 15%, SCC risk was increased 15%, and melanoma risk was increased 11%. “This association was robust after controlling for potential confounders, including host risk factors, outdoor tanning behavior, and UV index in the state of residence,” the investigators noted. They also found that compared with tanning bed use at the ages of 25 to 35 years (HR=1.28), a significantly higher risk was found for BCC when tanning beds were used during high school/college (HR=1.73; P<0.001).

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“These findings provide evidence to support warning the public against future use of tanning beds and enacting state and federal legislation to ban tanning bed use for those under age 18,” the study authors wrote, noting that California enacted such legislation on October 9, 2011; several initiatives have been launched in Brazil, Australia, France, and Germany. They concluded that these results, along with those of previous studies, “strongly suggest that policy makers promote restrictions on the indoor tanning industry.”