Tattooing and risk of melanoma: a population-based case-control study in Utah
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Background
Tattooing can deliver carcinogens directly into the skin and cause immunologic responses, yet the relationship between tattooing and melanoma risk is unknown.
Methods
In a population-based case-control study with 1,167 melanoma cases (566 in situ; 601 invasive) and 5,835 frequency-matched controls, we examined tattooing and melanoma risk using multivariable logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Results
While ever receiving a tattoo was not strongly associated with melanoma risk, heavier tattooing exposure was associated with decreased risk. Melanoma risk was decreased among individuals who had received four or more tattoo sessions (OR 0·44 [95% CI 0·27–0·67]) and individuals who had three or more large tattoos (OR 0·26 [95% CI 0·10–0·54) compared with those who were never tattooed. Invasive melanoma risk was decreased among individuals who received their first tattoo before age 20 (OR 0·48 [95% CI 0·29–0·82]) compared with never tattooed individuals. These patterns were stronger among men than women. Conversely, individuals who had only received one tattoo session had a higher risk of melanoma (OR 1·53 [95% CI 1·16–2·00) compared with individuals who were never tattooed, particularly for in situ melanoma (OR 1·85 [95% CI 1·31–2·63).
Conclusions
Our findings suggest a complex relationship between tattooing and melanoma risk. There was evidence of reduced melanoma risk with more tattoo exposure, but also increased risk among those who were only tattooed once. The potential causes of these seemingly contradictory associations could include a variety of factors including sun exposure-related behaviors or immune responses to timing and quantities of tattooing. These findings justify further investigation.
