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Open Access Publications from the University of California

Scholarly Works (6 results)

  • Article
  • Peer Reviewed
Dermatology Online Journal, Volume 22, Issue 9 (2016)
Given the popularity of a tan appearance, sunless tanning may play a role in skin cancer prevention as a substitute for ultraviolet (UV) tanning. Few studies have comprehensively assessed attitudes toward sunless tanning or predictors of use.Demographic, phenotypic, and lifestyle characteristics were ascertained during in-person interviews of 385 non-Hispanic whites (75 sessions vs no indoor tanning OR=3.30, 95% CI=1.52-7.16), a tendency to burn with first summer sun exposure (OR=1.89, 95% CI=1.03-3.47), higher public body consciousness (OR=1.09, 95%CI=1.02-1.18), and believing sunless tanning was useful for tanning when weather is not optimal for sunbathing (OR=5.08, 95% CI=2.11-12.22).Results suggest young adults find sunless tanning to be an acceptable method of achieving a tanned appearance. Sunless tanning may prove useful in reducing UV exposure, particularly among females who engage in sunbathing or indoor tanning.
    Cover page: Attitudes and predictors of sunless tanning in a sample of young adultsCreative Commons 'BY-NC-ND' version 4.0 license
    • Article
    • Peer Reviewed
    Dermatology Online Journal, Volume 22, Issue 9 (2016)

    Indoor tanning is an established risk factor for skin cancer, yet indoor tanning is quite common among adolescents. Laws exists in some states to limit access to indoor tanning by minors, but there is limited research on industry compliance with these laws.

    We conducted a telephone survey with a random sample of businesses (n=412) offering indoor tanning in the 14 states with indoor tanning bans for minors as of May 2015. Female research assistants posing as minors conducted telephone interviews with employees using a standardized script.

    The majority of businesses (73.5%) told the minor caller that she could not use the tanning facilities. However, 12.6% told her she could tan and 13.9% gave other inaccurate information related to parental permission. Among the businesses (n=368) that completed the full interview, when asked about dangers from indoor tanning 52.2% identified burning and 20.1% mentioned skin cancer. However, 21.7% said dangers were no worse than the sun, 11.4% said the booths in their business were safer than others, and 10.3% said there were no dangers. Many businesses stated benefits when asked, including vitamin D (27.7%), social/cosmetic (27.2%), and treatment of skin diseases (26.4%), with only 4.9% indicating no health benefits.

    While three-quarters of businesses followed the indoor tanning bans when a minor called, one- quarter were noncompliant. Many of the businesses made inaccurate health claims about indoor tanning. Additional enforcement may be necessary to increase compliance and other regulations are needed to penalize businesses from stating health benefits and presenting false risk information.

      Cover page: Compliance with indoor tanning laws for minors among salons and business in the United StatesCreative Commons 'BY-NC-ND' version 4.0 license
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2014)
      Tea and coffee are hypothesized to play a protective role in skin carcinogenesis through bioactive components, such as caffeine, yet the epidemiologic evidence is mixed. Existing data support an inverse association with basal cell carcinoma (BCC), more so than for melanoma or squamous cell carcinoma. To understand whether tea, coffee, and caffeine are related to early-onset BCC, we evaluated data from 767 non-Hispanic Whites under age 40 in a case-control study in Connecticut. BCC cases (n=377) were identified through Yale's Dermatopathology database. Controls (n=390) were randomly sampled from individuals in the same database with benign skin diagnoses and frequency matched to cases on age, sex, and biopsy site. Participants completed an in-person interview including assessment of caffeinated coffee and hot tea. We calculated multivariate odds ratios (ORs) and 95% confidence intervals (CIs) with unconditional logistic regression for regular consumption and frequency and duration measures. Combined regular consumption of caffeinated coffee plus hot tea was inversely associated with early-onset BCC (OR=0.60, 95% CI=0.38-0.96). Those in the highest category of caffeine from these sources had a 43% reduced risk of BCC compared with nonconsumers (OR=0.57, 95% CI=0.34-0.95, P-trend=0.037). Our findings suggest a modest protective effect for caffeinated coffee plus tea in relation to early-onset BCC that may, in part, be due to caffeine. This study adds to the growing body of literature suggesting potential health benefits from these beverages.
        Cover page: Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case–control study
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2012)
        Basal cell carcinoma (BCC) incidence is increasing, particularly among adults under the age of 40 years. Pigment-related characteristics are associated with BCC in older populations, but epidemiologic studies among younger individuals and analyses of phenotype-genotype interactions are limited. We examined self-reported phenotypes and melanocortin 1 receptor gene (MC1R) variants in relation to early-onset BCC. BCC cases (n=377) and controls with benign skin conditions (n=390) under the age of 40 years were identified through Yale's Dermatopathology database. Factors most strongly associated with early-onset BCC were skin reaction to first summer sun for 1 hour (severe sunburn vs. tan odds ratio (OR)=12.27, 95% confidence interval (CI)=4.08-36.94) and skin color (very fair vs. olive OR=11.06, 95% CI=5.90-20.74). Individuals with two or more MC1R non-synonymous variants were 3.59 times (95% CI=2.37-5.43) more likely to have BCC than those without non-synonymous variants. All host characteristics and MC1R were more strongly associated with multiple BCC case status (37% of cases) than a single BCC case status. MC1R, number of moles, skin reaction to first summer sun for 1 hour, and hair and skin color were independently associated with BCC. BCC risk conferred by MC1R tended to be stronger among those with darker pigment phenotypes, traditionally considered to be at low risk of skin cancer.
          Cover page: Host Phenotype Characteristics and MC1R in Relation to Early-Onset Basal Cell Carcinoma
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2015)
          Basal cell carcinoma (BCC) incidence is increasing, particularly in young people, and can be associated with significant morbidity and treatment costs. To identify young individuals at risk of BCC, we assessed existing melanoma or overall skin cancer risk prediction models and built a novel risk prediction model, with a focus on indoor tanning and the melanocortin 1 receptor gene, MC1R. We evaluated logistic regression models among 759 non-Hispanic whites from a case-control study of patients seen between 2006 and 2010 in New Haven, Connecticut. In our data, the adjusted area under the receiver operating characteristic curve (AUC) for a model by Han et al. (Int J Cancer. 2006;119(8):1976-1984) with 7 MC1R variants was 0.72 (95% confidence interval (CI): 0.66, 0.78), while that by Smith et al. (J Clin Oncol. 2012;30(15 suppl):8574) with MC1R and indoor tanning had an AUC of 0.69 (95% CI: 0.63, 0.75). Our base model had greater predictive ability than existing models and was significantly improved when we added ever-indoor tanning, burns from indoor tanning, and MC1R (AUC = 0.77, 95% CI: 0.74, 0.81). Our early-onset BCC risk prediction model incorporating MC1R and indoor tanning extends the work of other skin cancer risk prediction models, emphasizes the value of both genotype and indoor tanning in skin cancer risk prediction in young people, and should be validated with an independent cohort.
            Cover page: Indoor Tanning and the MC1R Genotype: Risk Prediction for Basal Cell Carcinoma Risk in Young People
            • Article
            • Peer Reviewed
            Dermatology Online Journal, Volume 22, Issue 9 (2016)

            Growing evidence suggests some individuals may exhibit dependence to ultraviolet light, a known carcinogen; however, few studies have investigated predictors of tanning dependence (TD).A sub-set of early-onset basal cell carcinoma case-control study participants completed an online survey. The modified-Cut down, Annoyed, Guilty, Eye-opener (mCAGE) and a questionnaire based on the addiction criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (mDSM-IV-TR) were used to classify participants having

            ‘Symptoms of TD’ if they met criteria for TD on both questionnaires, ‘Tendency for TD’ if met criteria on only one questionnaire, or ‘Not TD’. We also assessed lifetime alcohol dependence, nicotine dependence, seasonal affective disorder (SAD), ‘exercise addiction,’ and depression. We compared TD groups with multivariate logistic regression.499 individuals reported volitional tanning and 24.4% were classified as having ‘Symptoms of TD’ and 24.4% as having a ‘Tendency for TD’. Women were more likely to have ‘Symptoms of TD’ (odds ratio (OR)=6.93; 95% Confidence Interval (95% CI)=(3.36-14.27)) or a ‘Tendency for TD’ (OR=2.82; 95% CI=1.59-4.98) than men. Alcohol dependence (OR=6.55; 95% CI=3.19-13.42), alcohol abuse (OR=3.16; 95% CI=1.81-5.51), risk of ‘exercise addiction’ (OR=5.47; 95%=1.15-26.06) and SAD (OR=2.77; 95% CI=1.26-6.09) were all significant predictors for ‘Symptoms of TD’. Alcohol dependence (OR=3.66; 95% CI=1.84-7.31) and alcohol abuse (OR=2.60; 95% CI=1.53-4.41) were significant predictors for ‘Tendency for TD.’Knowledge of associations between TD and gender, alcohol dependence/abuse, SAD, and ‘exercise addiction’ may be helpful to practitioners in treating TD and for targeting skin cancer preventive interventions for those with TD.

              Cover page: Predictors of tanning dependence in white non-hispanic females and malesCreative Commons 'BY-NC-ND' version 4.0 license
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