At a time when melanoma cases are rising sharply in Minnesota, lawmakers appear poised to pass legislation that would ban anyone under 18 from using tanning equipment.
Bills sponsored by Rep. JoAnn Ward, DFL-Woodbury, and Sen. Chris Eaton, DFL-Brooklyn Center, sailed through House and Senate committees this month and now await floor votes in both bodies. The ban, which has been a controversial topic in previous sessions, now has had the support of the tanning industry.
Asbestos and tobacco have long been classified as substances that cause cancer in humans. In 2009, the World Health Organization's International Agency for Research on Cancer added tanning beds to that list.
Long before state cancer data revealed the trend, Dr. Cindy Firkins Smith started noticing an increase in melanoma cases in her practice.
When Smith, a Willmar dermatologist, started her career 20 years ago, she saw one case of melanoma a month, if that. Today she follows between 10 and 12 melanoma patients a day.
"It's a massive part of my practice now," said Smith. "I never imagined that when I started practicing."
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Melanoma, which largely occurs in older people, is the most deadly form of skin cancer. It is usually caused by overexposure to Ultraviolet light from either the sun or a UV-emitting device, such as a tanning bed.
The Minnesota Medical Association is among a dozen professional groups that support the proposed ban. They include hospitals, clinics and health plans. Smith, the association's president, said many young melanoma patients in her practice acknowledge frequently using tanning beds.
"It's the increased frequency in young adults, particularly young women that is the most shocking because we didn't used to see that," she said. "That's what has us really up in arms."
Data gleaned from Minnesota's Cancer Surveillance System show that melanoma rates have increased by more than a third in the last five years. During that time, rates for many other types of cancer have fallen.
The greatest increase in melanoma cases has been among younger, white women, between the ages of 20 and 49, said Dr. Jane Korn, medical director of the health promotion and chronic disease division for the Minnesota Department of Health.
"The rates are increasing at about 5 percent per year, and they've doubled since 1995," Korn said. "So melanoma is now the most common cancer diagnosed among women in their 20s."
To substantiate whether tanning beds might be behind the increase in melanoma cases, the health department added some tanning questions to the Minnesota Student Survey conducted last year.
"Melanoma is now the most common cancer diagnosed among women in their 20s."
The survey showed that one in three 11th grade girls reported that they tanned indoors in the last year. Among those tanning bed users, Korn said more than half reporting tanning indoors more than 10 times that year.
"I just don't think that people realize that it's dangerous," Korn said. "People think a tan makes you look healthy and that it's healthy. But it really isn't. It's a sign that you're damaging your skin."
Minnesota's proposed tanning equipment ban for people under age 18 has the support of the American Suntanning Association. But that doesn't mean that the industry agrees that it's promoting the use of a dangerous product.
Joseph Levy, the association's scientific advisor, said customers who are under 18 represent only 2 to 3 percent of the business for most tanning salon operators. He said the legislation is not worth a protracted fight.
"The issue about UV light has been monopolized by this topic and directed at this segment of the population," he said. "We think it's time to move on to discuss a more balanced approach."
Levy said the tanning industry is more interested in correcting the record when it comes to UV light. He said public health officials have given people the impression that all UV light is bad, when humans need some exposure to process vitamin D.
Minnesota's sharp increase in melanoma rates among young women is curious to Levy because it has not led to an increase in melanoma deaths. He says that makes him question whether dermatologists were accurately diagnosing young patients.
"We want to get the groups in Minnesota that have been, in the past, prone to overstatement ... to realize they don't need to do that moving forward," he said.
Korn, of the state health department, confirmed that deaths attributable to melanoma have remained stable, even among young women, despite Minnesota's increasing number of melanoma cases.
She said there are several possible reasons why deaths have not increased, including the possibility that the cancer was detected at an early stage and that treatment was effective.