Melanoma risk factors, perceived threat and intentional tanning: an international online survey

Abstract

Cutaneous melanoma continues to increase in incidence in many countries, and intentional tanning is a risk factor for melanoma. The aim of this study was to understand how melanoma risk factors, perceived threat and preferences for a suntan relate to intentional tanning. Self-report data were collected on behalf of GenoMEL (www.genomel.org) from the general population using an online survey. A total of 8178 individuals completed the survey, with 72.8% of respondents being from Europe, 12.1% from Australia, 7.1% from the US, 2.5% from Israel and 5.5% from other countries. Seven percent of respondents had previously been diagnosed with melanoma and 8% had at least one first-degree relative with a previous melanoma. Overall, 70% reported some degree of intentional tanning during the past year, and 38% of respondents previously diagnosed with melanoma had intentionally tanned. The total number of risk factors was positively correlated with perceived risk of melanoma [correlation coefficient (rho) = 0.27], and negatively correlated with intentional tanning (rho = -0.16). Preference for a dark suntan was the strongest predictor of intentional tanning [regression coefficient (beta) = 0.35, P<0.001], even in those with a previous melanoma (beta = 0.33, P<0.01). A substantial proportion of participants reported having phenotypic and behavioural risk factors for melanoma. The preference regarding suntans seemed more important in the participants' decision to intentionally tan than their perceived risk of developing melanoma, and this finding was consistent among respondents from different countries. The drive to sunbathe to tan is a key factor to be moderated if melanoma incidence is to be reduced.

Figure 1

Computer-generated pictures of people with varying levels of suntan used to assess respondents preferred level of tan.

Figure 2

Adjusted mean scores of intentional tanning (min=0, max=15) and their 99% confidence intervals by country of residence (adjusted for gender, age, skin type, hair colour, experience of sunburn before the age of 16, number of freckles, number of moles, family history of melanoma, and experience of own previous melanoma).

Figure 3

Mean levels of intentional tanning (possible range: 0–15), as a function of the interaction between objective risk (0–3, 4–5 or more than 5) and perceived threat (median split into low (<2.79) versus high (≥2.79)) among respondents with no previous experience of melanoma.