April 4 (UPI) -- Around 30 percent of people who participate in indoor tanning undergo cancer screening, according to a new study. But that may not be enough, researchers say, because of a higher risk of skin cancer from tanning.
The U.S. Food and Drug Administration recommends indoor tanners be screened regularly for skin cancer, and researchers report the percentage was more than 10 percentage points higher than the 19.5 percent of non-tanners in the study, published Wednesday in the Journal of American Medicine Association's Dermatology.
Nearly five million skin cancers are diagnosed each year in the United States and millions of Americans who have tanned indoors are at higher risk of melanoma and keratinocyte skin cancers than the general population, the Centers for Disease Control and Prevention reported.
In 2015, the FDA required manufacturers of indoor tanning devices to post warnings that "persons repeatedly exposed to UV radiation should be regularly evaluated for skin cancer."
And in December 2015, the FDA proposed a rule to require users to sign a risk acknowledgment certification before use and every six months thereafter that they were informed of health risks.
"Because these risk statements are relatively new and do not seem to have been well publicized, it is doubtful that most primary care physicians or indoor tanners are aware of them," researchers wrote in the study.
Although all tanning situations are harmful, it depends on type.
"Regardless of what the tanning industry says, we don't have studies saying some types are better," Dr. Carolyn Heckman, who was with Fox Chase Cancer Center in Philadelphia when the study was conducted, told UPI. "However, professional salons may be slightly better monitored than home devices. Indoor tanning or sunbathing contribute to almost all skin cancers. Indoor tanning seems to have an even stronger association."
Heckman, who now works for the Rutgers Cancer Institute of New Jersey, said "the more sessions over time, the greater the risk -- essentially a dose-response relationship." She notes, however, that just one visit "especially early in life, increases risk for skin cancer greatly."
Skin cancer can be detected relatively early, researchers say, but only if people are being screened on a regular basis.
"Cancer screening is associated with detection of thinner tumors, which are associated with lower mortality rates," the researchers wrote. "Research has not yet shown a direct mortality benefit for skin cancer screening, although screening is recommended for certain high-risk groups."
Researchers analyzed data from 30,352 U.S. adults who participated in the 2015 National Health Interview Study.
There were 4,987 indoor tanners, including 1,077 who tanned in the past year and 1,505 who screened for skin cancer. Of the individuals who reported being screened for skin cancer, 68.5 percent said that it was part of a routine medical examination, 23.6 percent said that it was because of a problem and 7.7 reported "other" as the reason.
The researchers noted that indoor tanners were more likely to be non-Hispanic whites.
The researchers found in both groups screening was more prevalent for older age, higher income, those seeking online health information, people with a family history of skin cancer, those who use sunscreen with a high sun protection factor and people who have received a professional spray-on tan in the past 12 months.
"The study by Heckman et al provides valuable information and is a necessary first step to enhance our understanding of skin screening in indoor tanners," Dr. Mary K. Tripp, of Department of Behavioral Science at University of Texas MD Anderson Cancer Center in Houston, wrote in an accompanying editorial in the JAMA issue. "It is critical to extend research to guide the development and evaluation of skin screening interventions."
Few studies have been conducted, Tripp wrote, saying that "qualitative research would enable in-depth examination of skin screening barriers, facilitators and other underlying factors in indoor tanners."
"Additional research is needed to better understand which factors may be most critical to address with intervention to promote skin screening in indoor tanners specifically," Tripp said.
Heckman recommends exploring alternative methods of tanning that don't use light.
"Sunless tanning or other ways to enhance appearance such as exercise or healthy diet are preferable," she said.