Epidemiology and Genetics of Tanning Addiction

描述（由申请人提供）：尽管对紫外线（UV）的有害影响有广泛的了解和教育，但黑色素瘤和非黑色素瘤皮肤癌的发病率仍在继续增加。为了使行为干预有效，理解行为背后的因素是至关重要的。最近的研究表明，紫外线照射可能会产生生理效应（如内啡肽的释放），从而激发晒黑行为，而晒黑成瘾可能是一种生理现象，正如其他成瘾行为所显示的那样，可能存在遗传修饰因素。由于我们在早期发病（40岁以下）基底细胞癌（BCC）的大型病例对照研究中收集了大量关于晒黑行为和晒黑态度的数据，并获得了DNA样本，因此我们有一个独特的机会来经济有效地评估这一新的假设。我们建议在BCC病例对照研究的背景下评估晒黑依赖（通过与普遍认可的物质依赖形式的类比来定义）以及晒黑依赖与成瘾风险基因之间的关系。更具体地说，我们建议对我们早发性皮肤癌研究的参与者进行一项额外的调查，以评估晒黑依赖（成瘾），这将使我们能够解决以下目标：(1)按性别评估病例和对照组中晒黑依赖的患病率；(2)评估晒黑依赖（成瘾）与实际晒黑行为（如室内和室外晒黑）之间的关系；也就是说，有多少年轻人的晒黑行为可以用上瘾来解释？(3)评估被认为与多种成瘾类型相关的候选基因（阿片通路成员和昼夜节律基因）在晒黑成瘾中的作用。这些数据将与我们的病例对照研究数据协同作用，提供与皮肤癌风险相关的晒黑动机和行为的全面图景。如果我们发现与晒黑成瘾有关的基因与其他类型的成瘾有关，这将保证新的方法来减少依赖者的有害暴露，就像对其他有害的成瘾障碍所做的那样。

DESCRIPTION (provided by applicant): Despite extensive knowledge and education about the harmful effects of ultraviolet (UV) light, the incidence of melanoma and non-melanoma skin cancers is continuing to increase. For behavioral interventions to be effective, it is critical to understand the factors that underlie behaviors. Recent research suggests there may be physiological effects of UV exposure (e.g. release of endorphins) that motivate tanning behaviors, and that tanning addiction may be a physiological phenomenon, with possible genetic modifiers as has been shown for other addictive behaviors. As we are collecting extensive data on tanning behaviors and attitudes towards tanning within our large case-control study on early onset (aged under 40) basal cell carcinoma (BCC), and have DNA samples, we have a unique opportunity to cost-effectively evaluate this newer hypothesis. We propose to assess tanning dependence (defined by analogy with generally-recognized forms of substance dependence) and the relationship between tanning dependence and addiction risk genes within the setting of our BCC case-control study. More specifically, we propose to administer an additional survey to assess tanning dependence (addiction) to participants of our study of early onset skin cancer, which will allow us to address the following aims: (1) To assess the prevalence of tanning dependence in cases and controls, by sex; (2) To assess the association between tanning dependence (addiction) and actual tanning behaviors (e.g., indoor and outdoor tanning); that is, how much of tanning behavior in young people is explained by addiction?; (3) To assess the role of candidate genes that are thought to be related to multiple types of addiction (members of the opioid pathway, and circadian rhythm genes) in tanning addiction. These data will synergize with our case-control study data to provide a comprehensive picture of tanning motivation and behavior in relation to skin cancer risk. If we find involvement of genes in tanning addiction that are related to other types of addiction, this would warrant new approaches to reduce harmful exposures in dependent persons as has been done with other harmful addictive disorders. PUBLIC HEALTH RELEVANCE: The proposed study will investigate the epidemiology and genetics of tanning dependence (addiction) which will help us better understand motivation for tanning and open new avenues for development of innovative interventions to reduce ultraviolet light exposure and ultimately reduce melanoma and nonmelanoma skin cancers. Developing more effective interventions is essential as skin cancer is the most common cancer in the United States and the incidence of both melanoma and nonmelanoma skin cancer continues to increase.