WASHINGTON — The Food and Drug Administration on Friday proposed barring everyone under 18 from using tanning beds, a sweeping move that medical experts say is a major step toward reducing the risk of skin cancer in the United States.
For decades, medical researchers saw indoor tanning as little more than a curiosity. But evidence has been gathering that tanning beds may play more of a role in the nation's cancer numbers than originally thought. A review of the scientific research published last year estimated that tanning beds account for as many as 400,000 cases of skin cancer in the United States each year, including 6,000 cases of melanoma, the deadliest form.
And unlike most other cancers, where the rates of new cases are flat or declining, melanoma has continued to rise by about 3 percent a year for the last couple of decades. Health experts worry that tanning beds — still popular, particularly among young women — are a significant contributor.
Some states have already banned the practice for minors, but the service is still broadly accessible in most states, with salons dotting strip malls across the country and tanning beds popping up in places like gyms, college campuses and spas. A 2014 study by University of Miami researchers found more tanning salons in Florida than McDonald's restaurants, CVS stores or Bank of America branches.
"This is a tremendous advance," said Dr. Jeffrey E. Gershenwald, a professor of surgery and the medical director of the Melanoma and Skin Center at the University of Texas M.D. Anderson Cancer Center. "There will now be a national order against using indoor tanning devices for youth around the country. It will no longer be dependent solely on grass-roots state and local initiatives."
Eric Pahon, a spokesman for the FDA, said the agency would work through state authorities to enforce the proposed requirements, if they become final. Manufacturers of the beds already have to register with the FDA, he said, but tanning salons do not, and some experts said the proposal could be tricky to enforce. He said the agency could enforce the order by seizing devices, filing civil penalties with fines or even criminally prosecuting.
The proposal is important, health experts say, because young people are most at risk from the health consequences of indoor tanning. The risk of melanoma jumps by 59 percent in people who use tanning beds before age 35. Overall, indoor tanning increased the risk of melanoma by 20 percent, studies have found. The FDA proposal will be open for public comment for 90 days.
"Indoor tanning is particularly dangerous for younger users," said Dr. Vasum Peiris, chief medical officer for pediatrics and special populations at the FDA's Center for Devices and Radiological Health.
The proposal, if made final, would be broad-reaching. There are 18,000 to 19,000 indoor tanning salons in the United States and as many as 20,000 other facilities, such as health clubs, offering tanning services, according to the FDA.
The Indoor Tanning Association said in a statement that the industry is "heavily regulated at both the federal and state levels and our customers are well aware of the potential risks of overexposure."
It added, "We are concerned that the proposed requirements will burden our members with additional unnecessary governmental costs in an already difficult economic climate."
The number of young people using tanning beds has started to decline in recent years, but the figure is still high — about 1.6 million minors tan indoors every year, according to a federal youth health survey from 2013.
But those who use them, use them frequently. The federal government has collected data on tanning among high school students only since 2009, but researchers were surprised at the findings: Among those who used tanning beds, more than half had used them 10 times or more in the past year.
The FDA also proposed new preventive measures for adults, including that they sign a document before using a tanning bed saying that they understand the risks. The agency is also requiring tanning bed companies and manufacturers to make warning labels more prominent and easier to read, have an emergency shut-off switch, and make sure protective eyewear is worn during tanning sessions block out more light.
More than 40 states now have some sort of restriction on the use of tanning salons by minors, according to AIM at Melanoma, an advocacy and research group based in California, which in 2011 became the first state to prohibit minors from using them. There are now at least 11 states, plus the District of Columbia, with full under-18 bans, according to AIM, including Texas, Hawaii, Louisiana, Minnesota, Illinois and North Carolina.