Liz Szabo, USA TODAY
The number of people using indoor tanning services is substantially higher than previously reported, a new international study finds.
More than 35% of American adults report ever using a tanning bed, along with 59% of college students and 17% of teens in the analysis. The percentage of Americans who have used a tanning bed in the past year also was high -- 13% of adults, 43% of university students and 10% of teens, according to the report published Wednesday in JAMA Psychiatry. The study also measured rates in Europe and Australia, where rates were comparable.
That trend could foretell an alarming rise in skin cancer, whose rates have been rising for decades, especially among young women, said Timothy Turnham, executive director of the Melanoma Research Foundation, who was not involved in the new study.
Since 1992, U.S. rates of melanoma - once considered an old person's disease - have risen 3% a year in white women ages 15 to 39, according to the American Cancer Society. People who use a tanning salon before age 35 increase their risk of melanoma by 75%, according to the Centers for Disease Control and Prevention.
Based on the high number of people using tanning beds, authors of the study estimate that the devices cause 388,079 cases of skin cancer each year in the USA - more than twice as many as estimated in earlier analyses and thousands more than the 200,000 lung cancers caused by smoking each year. Lung cancer kills far more than skin cancer, according to the American Cancer Society.
The Food and Drug Administration estimates that about 30 million Americans use indoor tanning beds each year, including 2.3 million teens.
The new study suggests that the practice is actually much more common, with 38 million Americans engaging in indoor tanning, said Joe Levy, a spokesman for the American Suntanning Association, which represents tanning salon owners. The number of tanning salons in the USA has declined 30% in the past decade, however, calling into question whether tanning is as common as the study suggests. "These numbers simply don't jibe with reality," Levy said. His organization urges consumers to "tan responsibly," and he said most of the risk from indoor tanning comes from home machines used without professional supervision.
Richard Wender, chief cancer control officer at the American Cancer Society, described the new study as highly credible, noting that it was based on responses by more than 491,000 people.
Authors of the report didn't do any new surveys of their own. Instead, they analyzed results from 88 previous studies, said author Eleni Linosof the University of California-San Francisco. "Our estimates are more precise than prior individual studies," Linos said.
In 2011, the CDC's Youth Risk Behavior Surveillance System found that 32% of 12th-grade girls had used a tanning bed. Indoor tanning is most popular among young white women, studies show, and rates vary in different parts of the country. A 2010 CDC survey found that 44% of Midwestern white women ages 18 to 21 had used a tanning bed, along with 36% of women ages 22 to 25 in the South.
Six states have banned indoor tanning in people under age 18. Many other states restrict tanning in minors or require parental permission. Others are considering banning the practice for teens, according to the National Conference of State Legislatures.
Turnham said states should aim to reduce indoor tanning using strategies proven to work against tobacco, such as banning the practice in minors, educating people about the risks and increasing taxes.
The American Medical Association, American Academy of Pediatrics, American Academy of Dermatology and World Health Organization all have called on states to bar children under 18 from tanning salons.