FASHION TRENDS LINKED TO INCREASE IN MELANOMA
A century's worth of
cultural and historical forces have contributed to the rise in the incidence of
melanoma, including changes in fashion and clothing design, according to an
intriguing, retrospective research study conducted by investigators in the
Ronald O. Perelman Department of Dermatology at NYU Langone Medical Center
Their findings are the
subject of a report, "More Skin, More Sun, More Tan, More Melanoma,"
in the October 6, 2014 issue of the American Journal of Public Health.
The authors surmised
that early diagnosis and improved reporting practices do not fully account for
the steady rise in cases of melanoma. They set out to explore extenuating
factors that may also have contributed to the increase in reported cases in the
U.S.
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, they looked into the
transformative effect of socioeconomic trends dating from the1900's. They
analyzed clothing styles, social norms, medical paradigms, perceptions of
tanned skin, economic trends and travel patterns.
For comparisons
between periods, they estimated percentage of exposed areas of the body. For
example, early in the 20th century people donned clothing that
almost totally concealed the body from head to toe. "Porcelain" skin
was favored over the "tanned" skin, which was associated with a lower
class of people who worked outdoors.
Changes in medical
practice also would pave the way for a shift.
"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 lay circles, this medical prescriptive translated into a
growing belief in the benefit of tanning.People also began to enjoy more
leisure time and to favor swimwear and sportswear that progressively covered
less skin. Voices that raised concern about the dangers of UV exposure were
largely ignored.
Another contributing
factor, the researchers concluded, has been the reversal in attitude about
tanned skin, which became a sign of the leisurely upper class quality of life
and good health. Graphs tracking the incidence by year and percentage of
estimated skin exposure show that these developments rose in parallel with the
rise in melanoma cases in the U.S.
The increased
incidence of melanoma over the years has been a particular concern, especially
with the average age of diagnosis and death from melanoma trending younger than
for most of the other major cancers. "Years-of-life lost to melanoma is
nearly as high as breast cancer," Dr. Polsky said.
The study, however,
did cite one positive trend -- down under. Australia, widely considered the
"skin cancer capital of the world" according to Dr. Polsky, has
managed to turn things around, possibly with the help of a public education
campaign and a change of view about tanning -- thus giving other places still
basking in the sun a glimmer of hope.
"Attitudes and
behaviors shape exposures. More skin, more sun and more tan lead to more
melanoma," Dr. Polsky concluded.
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