I find news stories like this very disconcerting. Researchers at Harvard Medical School report that tanning bed use increases the risk of malignant melanoma. The increased risk is particularly prevalent among younger sunbed users. To me, this means that there will be an increase in claims arising out of a delay in diagnosis of this dangerous skin cancer. Here’s why…
When the demographics of illness change, doctors are slow to adjust. Worse yet, doctors often bring an inherent bias to encounters with younger patients that can interfere with sound medical judgment. Thus, when young people present with cancers that are usually found in older people, doctors may erroneously discount the possibility of cancer and give the younger patient less thorough care. We have seen this with young women who present with breast lumps. Despite the fact that >10% of breast cancer occurs in patients <age 40, doctors will often disregard complaints about new breast lumps in these patients when the standard of care demands imaging and biopsy.
In light of the Harvard study, physician organizations, like the American Pediatric Association and American Medical Association, should sound a warning bell and publish guidelines for advising patients who engage in sunbed use or frequent tanning to get regular dermatological exams by a board-certified dermatologist. This will never happen because physicians cower at the thought of having guidelines that they can be held accountable for.
The Harvard study confirms that indoor tanning causes melanoma, particularly among young sunbed users. There is a 20% increase in risk for melanoma with any indoor tanning and the risk nearly doubles when sunbed use begins before age 35. Sunbeds can be 10 to 15 times stronger than sunlight. So, young users can get a lifetime of exposure in short order. If they are uninformed enough to participate such activity, they will likely be uninformed about the dangerous consequences of the activity. Therefore, physicians, who bear responsibility for engaging in preventative care such as screening and offering medical advice about the consequences of high-risk behaviors, must screening for abnormal-looking moles and warn patients about the risks of tanning.
The best idea would be to ban these absurd devices — they serve no useful function and put young people at significant risk. Short of that, sunbed users will have to engage in life-long surveillance with the assistance of vigilant professionals. They will also need to rely on physicians to carefully biopsy any unusual pigmented lesion that is found. If the physician’s reasoning is that “the patient is so young that I didn’t consider the possibility of skin cancer,” there may be a basis for a medical malpractice claim.
