A new study published in the American Journal of Public Health titled “More Skin, More Sun, More Tan, More Melanoma”, links cultural and historical forces to the increased incidence of melanoma, including changes in fashion and clothing design.
The research team, led by David Polsky, MD, PhD, Alfred W. Kopf, MD Professor of Dermatologic Oncology in the Ronald O. Perelman Department of Dermatology at NYU Langone, used data from the national cancer registries to compare melanoma incidence rates with estimated skin exposure. They analyzed the transformative effect of socioeconomic trends dating from the1900’s, including clothing styles, social norms, medical paradigms, perceptions of tanned skin, economic trends and travel patterns.
To directly compare between periods, the authors estimated the percentage of exposed areas of the body, since in the beginning of the 20th century, people used clothing that protected the majority of the body to the damaging effects of the sun, since fairer skin was preferred over tanned skin.
“In the early 20th century, sunshine became widely accepted as treatment for rickets and tuberculosis, and was considered to be good for overall general health,” Dr. Polsky said in a NYU Langone Medical Center press release.
This translated into a change of mentality regarding the benefits of tanning. Furthermore, people also began to enjoy leisure time at the beach, using swimwear that covered less skin.
According to the authors, a crucial factor was the change in attitude towards tanned skin, which started to be seen as a symbol of upper class quality of life and good health.
In their study, researchers could observe that estimated skin exposure increased in parallel with reported melanoma cases in the U.S.
More recently, however, melanoma incidence has increased and the average age at diagnosis has become lower, with years-of-life lost to melanoma almost as high as breast cancer.
The authors conclude in their study “Attitudes and behaviors shape exposures. Although causation cannot be made in an analysis such as this one, we have provided a historical framework for the changing attitudes promoting increased UV exposure and the rising incidence of melanoma throughout the past century. The desire to be tan, which has its roots in the medical profession, retains its popularity today despite evidence linking UV exposure to skin cancer. How public health measures will positively affect long-term melanoma incidence rates remains to be seen”.