An Ecological Study Indicates the Importance of Ultraviolet A Protection in Sunscreens
DOI:
https://doi.org/10.2340/00015555-3788Keywords:
sunscreen, ultraviolet rays, ultraviolet A;, melanoma, epidemiologyAbstract
The use of sunscreens is recommended to limit the impact of sun exposure on the skin. The objective of this study was to examine the relationship between sunscreen sales and melanoma in 4 different countries with diverse sunscreen regulations. Data from publicly available databases were examined for Sweden, England, Australia, and the USA from 1999 to 2018. The association between incidence of melanoma and sunscreen sales was estimated using a generalized estimating equation, and modelling was used to predict melanoma cases. Incidence of melanoma was positively associated with sunscreen sales in England, Australia, and the USA, and negatively associated with sunscreen sales in Sweden. Growth rates in melanoma cases of 0.42%, 16.7%, 19.1% and 12.2% were predicted for Sweden, England, Australia, and the USA, respectively. The differences observed between England, Australia, and the USA, on the one hand, and Sweden, on the other hand, are consistent with the adoption of strong regulations requiring the use of ultraviolet A blocking agents in sunscreens.
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Matthews NH, Li W-Q, Qureshi AA, Weinstock MA, Cho E. Epidemiology of Melanoma. In: Ward WH, Farma JM, editors. Cutaneous melanoma: etiology and therapy. Brisbane (AU): Codon Publications; 2017 [cited 2019 Dec 11]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK481862/.
Melanoma Skin Cancer Statistics. The American Cancer Society. [cited 2019 Sep 20]. Available from: https://www.cancer.org/cancer/melanoma-skin-cancer/about/key-statistics.html.
Melanoma of the Skin - Cancer Stat Facts. SEER. [cited 2020 May 20]. Available from: https://seer.cancer.gov/statfacts/html/melan.html.
Sacchetto L, Zanetti R, Comber H, Bouchardy C, Brewster DH, Broganelli P, et al. Trends in incidence of thick, thin and in situ melanoma in Europe. Eur J Cancer 2018; 92: 108-118.
https://doi.org/10.1016/j.ejca.2017.12.024
Dimitriou F, Krattinger R, Ramelyte E, Barysch MJ, Micaletto S, Dummer R, et al. The world of melanoma: epidemiologic, genetic, and anatomic differences of melanoma across the globe. Curr Oncol Rep 2018; 20: 1-9.
https://doi.org/10.1007/s11912-018-0732-8
Koh HK, Geller AC, Miller DR, Grossbart TA, Lew RA. Prevention and early detection strategies for melanoma and skin cancer: current status. Arch Dermatol 1996; 132: 436-443.
https://doi.org/10.1001/archderm.1996.03890280098014
Saraiya M, Glanz K, Briss P, Nichols P, White C, Das D; Task Force on Community Preventive Services On reducing Exposure to Ultraviolet Light. Preventing skin cancer: findings of the Task Force on Community Preventive Services On reducing Exposure to Ultraviolet Light. MMWR Recomm Rep. 2003; 52: 1-12.
https://doi.org/10.1001/archderm.140.2.251-a
Silva ES da, Tavares R, Paulitsch F da S, Zhang L. Use of sunscreen and risk of melanoma and non-melanoma skin cancer: a systematic review and meta-analysis. Eur J Dermatol 2018; 28: 186-201.
https://doi.org/10.1684/ejd.2018.3251
Williams SN, Dienes KA. Sunscreen sales, socio-economic factors, and melanoma incidence in Northern Europe: a population-based ecological study. SAGE Open 2014; 4: 2158244014559023.
https://doi.org/10.1177/2158244014559023
Liu T, Soong SJ. Epidemiology of malignant melanoma. Surg Clin North Am 1996; 76: 1205-1222.
https://doi.org/10.1016/S0039-6109(05)70511-9
Eide MJ, Weinstock MA. Association of UV index, latitude, and melanoma incidence in nonwhite populations - US Surveillance, Epidemiology, and End Results (SEER) Program, 1992 to 2001. Arch Dermatol 2005; 141: 477-481.
https://doi.org/10.1001/archderm.141.4.477
Rivas M, Rojas E, Calaf GM. Prediction of skin cancer occurrence by ultraviolet solar index. Oncol Lett 2012; 3: 893-896.
Stang A, Becker JC, Nghiem P, Ferlay J. The association between geographic location and incidence of Merkel cell carcinoma in comparison to melanoma: an international assessment. Eur J Cancer 2018; 94: 47-60.
https://doi.org/10.1016/j.ejca.2018.02.003
United Nations Statistics division - environment statistics. [cited 2021 Jan 20]. Available from: https://unstats.un.org/unsd/environment/ODS_Consumption.htm.
Romerdahl CA, Donawho C, Fidler IJ, Kripke ML. Effect of ultraviolet-B radiation on the in vivo growth of murine melanoma cells. Cancer Res 1988; 48: 4007-4010.
The Relationship between Income, Consumption and GDP: a time series, cross-country analysis. Proc Econ Finan 2015; 23: 1535-1543.
https://doi.org/10.1016/S2212-5671(15)00374-3
Idorn LW, Wulf HC. Socioeconomic status and cutaneous malignant melanoma in Northern Europe. Br J Dermatol 2014; 170: 787-793.
https://doi.org/10.1111/bjd.12800
Singh SD, Ajani UA, Johnson CJ, Roland KB, Eide M, Jemal A, et al. Association of cutaneous melanoma incidence with area-based socioeconomic indicators - United States, 2004-2006. J Am Acad Dermatol 2011; 65: S58-S68.
https://doi.org/10.1016/j.jaad.2011.05.035
Bentham G, Aase A. Incidence of malignant melanoma of the skin in Norway, 1955-1989: associations with solar ultraviolet radiation, income and holidays abroad. Int J Epidemiol 1996; 25: 1132-1138.
https://doi.org/10.1093/ije/25.6.1132
Pérez-Gómez B, Aragonés N, Gustavsson P, Lope V, López-Abente G, Pollán M. Socio-economic class, rurality and risk of cutaneous melanoma by site and gender in Sweden. BMC Publ Health 2008; 8: 33.
https://doi.org/10.1186/1471-2458-8-33
Johnson-Obaseki SE, Labajian V, Corsten MJ, McDonald JT. Incidence of cutaneous malignant melanoma by socioeconomic status in Canada: 1992-2006. J Otolaryngol Head Neck Surg 2015; 44: 53.
https://doi.org/10.1186/s40463-015-0107-1
Kojo K, Jansen CT, Nybom P, Huurto L, Laihia J, Ilus T, et al. Population exposure to ultraviolet radiation in Finland 1920-1995: exposure trends and a time-series analysis of exposure and cutaneous melanoma incidence. Environ Res 2006; 101: 123-131.
https://doi.org/10.1016/j.envres.2005.09.007
Rueegg CS, Stenehjem JS, Egger M, Ghiasvand R, Cho E, Lund E, et al. Challenges in assessing the sunscreen-melanoma association. Int J Cancer 2019; 144: 2651-2668.
https://doi.org/10.1002/ijc.31997
Xie F, Xie T, Song Q, Xia S, Li H. Analysis of association between sunscreens use and risk of malignant melanoma. Int J Clin Exp Med 2015; 8: 2378-2384.
Guide to the development, evaluation and implementation of clinical practice guidelines. National Health and Medical Research Council. [cited 2020 Mar 26]. Available from: https://www.nhmrc.gov.au/about-us/publications/guide-development-evaluation-and-implementation-clinical-practice-guidelines.
Autier P, Boniol M, Doré J-F. Sunscreen use and increased duration of intentional sun exposure: still a burning issue. Int J Cancer 2007; 121: 1-5.
https://doi.org/10.1002/ijc.22745
Autier P, Doré J-F, Reis AC, Grivegnée A, Ollivaud L, Truchetet F, et al. Sunscreen use and intentional exposure to ultraviolet A and B radiation: a double-blind randomized trial using personal dosimeters. Br J Cancer 2000; 83: 1243-1248.
https://doi.org/10.1054/bjoc.2000.1429
Wheless L, Ruczinski I, Alani RM, Clipp S, Hoffman-Bolton J, Jorgensen TJ, et al. The association between skin characteristics and skin cancer prevention behaviors. Cancer Epidemiol Biomarkers Prev 2009; 18: 2613-2619.
https://doi.org/10.1158/1055-9965.EPI-09-0383
Jansen R, Osterwalder U, Wang SQ, Burnett M, Lim HW. Photoprotection: part II. Sunscreen: development, efficacy, and controversies. J Am Acad Dermatol 2013; 69: 867.e1-14; quiz 881-2.
https://doi.org/10.1016/j.jaad.2013.08.022
Commission Recommendation of 22 September 2006 on the efficacy of sunscreen products and the claims. Official Journal of the European Union 2006; 265. Available from: http://data.europa.eu/eli/reco/2006/647/oj/eng.
Labeling and effectiveness testing: sunscreen drug products for over-the-counter human use - small entity compliance guide. US Food and Drug Administration (FDA); 2019 [cited 2020 Mar 28]. Available from: http://www.fda.gov/regulatory-information/search-fda-guidance-documents/labeling-and-effectiveness-testing-sunscreen-drug-products-over-counter-human-use-small-entity.
Australian regulatory guidelines for sunscreens. Australian Government Department of Health- Therapeutic Goods Administration; 2019 [cited 2020 Mar 28]. Available from: https://www.tga.gov.au/publication/australian-regulatory-guidelines-sunscreens-args.
Wang SQ, Lim HW. Highlights and implications of the 2019 proposed rule on sunscreens by the US Food and Drug Administration. J Am Acad Dermatol 2019; 81: 650-651.
https://doi.org/10.1016/j.jaad.2019.04.007
Wang SQ, Setlow R, Berwick M, Polsky D, Marghoob AA, Kopf AW, et al. Ultraviolet A and melanoma: a review. J Am Acad Dermatol 2001; 44: 837-846.
https://doi.org/10.1067/mjd.2001.114594
Latha MS, Martis J, Shobha V, Sham Shinde R, Bangera S, Krishnankutty B, et al. Sunscreening agents. J Clin Aesthet Dermatol 2013; 6: 16-26.
Kamenisch Y, Ivanova I, Drexler K, Berneburg M. UVA, metabolism and melanoma: UVA makes melanoma hungry for metastasis. Exp Dermatol 2018; 27: 941-949.
https://doi.org/10.1111/exd.13561
Matta MK, Florian J, Zusterzeel R, Pilli NR, Patel V, Volpe DA, et al. Effect of sunscreen application on plasma concentration of sunscreen active ingredients: a randomized clinical trial. JAMA 2020; 323: 256-267.
https://doi.org/10.1001/jama.2019.20747
National Institutes of Health summary of the Consensus Development Conference on Sunlight, Ultraviolet Radiation, and the Skin. Bethesda, MD, May 8-10, 1989. Consensus Development Panel. J Am Acad Dermatol 1991; 24: 608-612.
https://doi.org/10.1016/S0190-9622(08)80159-4
Savoye I, Olsen CM, Whiteman DC, Bijon A, Wald L, Dartois L, et al. Patterns of ultraviolet radiation exposure and skin cancer risk: the E3N-SunExp Study. J Epidemiol 2018; 28: 27-33.
https://doi.org/10.2188/jea.JE20160166
Ghiasvand R, Weiderpass E, Green AC, Lund E, Veierød MB. Sunscreen use and subsequent melanoma risk: a population-based cohort study. JCO 2016; 34: 3976-3983.
https://doi.org/10.1200/JCO.2016.67.5934
Klug HLP, Tooze JA, Graff-Cherry C, Anver MR, Noonan FP, Fears TR, et al. Sunscreen prevention of melanoma in man and mouse. Pigment Cell Melanoma Res 2010; 23: 835-837.
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Copyright (c) 2021 Samar Merhi, Pascale Salameh, Peter Kaplan, Shayak Banerjee, Mohamed Lajnef, Emmanuel L.P. Dumont, Khaled Ezzedine
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