PS03 (P134) Tanning dependence and associated psychopathologies: an opportunity to intervene in skin cancer clinics

Abstract Overall, 86% of cutaneous malignant melanomas (CMMs) in the UK are caused by ultraviolet radiation exposure, and approximately 100 annual deaths from CMM are estimated to be attributable to indoor tanning [Cancer Research UK. Melanoma skin cancer risk. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/melanoma-skin-cancer/risk-factors#heading-Three (last accessed 19 February 2025)]. However, despite health information campaigns, indoor tanning practices remain prevalent. Tanning has been associated with many psychological conditions, and tanning behaviour, such as continuing to tan despite the known harmful effects of ultraviolet radiation, is in keeping with the criteria for addiction [Miller KA, Mays D. Tanning as an addiction: the state of the research and implications for intervention. In: The Cambridge Handbook of Substance and Behavioral Addictions (Sussman S, ed.). Cambridge: Cambridge University Press, 2020; 362–72.3]. Furthermore, the tanning process generates beta-endorphin, which has mood-enhancing influences thought to mediate addiction. Although various authors have introduced measures of tanning dependence, there remains no consensus about which to use in clinical practice. We conducted a systematic review and meta-analysis to provide definitive estimates of the prevalence of tanning dependence and of associations between indoor tanning and other psychological conditions. Our review determined the prevalence of tanning dependence among people who currently tan indoors and people who have ever tanned indoors: the pooled estimates were 26% (95% confidence interval 0.10–0.45, P = 0.06) and 14% (95% confidence interval 0.01–0.37, P < 0.01), respectively. As more than one in four people who tan indoors experience dependence, these findings suggest that information campaigns alone may not be adequate tanning prevention strategies. The relatively recent recognition of the psychological risks of indoor tanning may also mean that people experiencing problematic tanning are not accessing behavioural interventions they may benefit from. It would be pertinent to establish a screening system for people at risk of tanning dependence to be utilized in clinical practice as part of primary or secondary prevention. Clinicians should also be cognizant of the other psychopathologies associated with indoor tanning. This would enable the psychological factors contributing to tanning decisions to be identified, which can then enable initiation of appropriate management. Dermatologists need to be equipped with evidence-based guidelines, incorporating pathways for managing problematic tanning, and validated, recommended tools for assessing tanning dependence. Better awareness and understanding of tanning dependence and tanning-related psychopathology would have the effect of reducing both the carcinogenic and psychological consequences of indoor tanning.