Medical Research: What are the main findings of the study?
Dr. Polsky: We utilized a multi-disciplinary approach including an analysis of socioeconomic factors to elucidate the evolution of attitudes and behaviors maximizing personal ultraviolet light exposure during the 20th century in the United States. We then compared melanoma incidence rates from national cancer registries to estimated skin exposure and found that they rose in parallel. Though causation cannot be made in an analysis such as this one, this paper describes a historical context for the changing attitudes promoting increased UV exposure, and the rising incidence of melanoma throughout the past century. It also provides a framework in which to consider public health and education measures that may ultimately help reverse melanoma incidence trends.
Medical Research: What was most surprising about the results?
Dr. Polsky: I was not aware that the desirability of a tan has its roots in medical science, and that tanning was promoted as a treatment for many illnesses for which it is clearly of no benefit.
Medical Research: What should clinicians and patients take away from your report?
Dr. Polsky: The desirability of tanned skin is cultural. In Asia, people spend large sums of money on products to lighten their skin. As a nation, we didn’t always want to be tan. If people’s attitudes toward tanned skin made it less desirable, we may see decreases in the incidence of melanoma.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Polsky: We believe that our analytical approach (i.e. studying the attitudes and behaviors that drive public health issues) could be applied to other areas such as tobacco cessation, alcohol use, and obesity. It would be worth studying whether public health interventions that identify and address the roles of cultural and historical forces that contribute to the growth and persistence of public health problems are more effective than more traditional interventions that may not take these factors into account.
Caroline Chang, MD, Era Caterina Murzaku, BS, Lauren Penn, MD, Naheed R. Abbasi, MD, MPH, Paula D. Davis, MFA, Marianne Berwick, PhD, MPH, and David Polsky, MD, PhD. More Skin, More Sun, More Tan, More Melanoma. American Journal of Public Health, October 2014 DOI: 10.2105/AJPH.2014.302185