An advisory panel recommended Friday that the state Health Department revise language on its parental consent form for indoor tanning to specify that the practice can cause skin cancer.
The recommendation by the Maryland State Council on Cancer Control supports plans by the state Department of Health and Mental Hygiene to change the parental consent's current wording to emphasize cancer risks more clearly. But unlike a draft the Health Department crafted last winter, it stops short of saying that indoor tanning devices cause cancer.
The panel's recommendation followed a discussion by medical experts and members of the tanning industry. The parental consent form was released one year after the General Assembly adopted legislation prohibiting use of tanning devices by those under 18 without such consent.
The wording of the consent form's final language is up to state Health Secretary Dr. Joshua Sharfstein, who said he hopes to decide before winter.
"My view is that parents deserve the facts before they decide to give any consent for indoor tanning," said Sharfstein, who said that Friday's discussion follows two public comment periods and two advisory meetings and comes amid concerns among oncologists about the form's accuracy and clarity.
The form currently reads: "Because of the increase in skin cancer and other skin problems related to exposures to ultraviolet light, most health experts recommend that children under age 18 should not use indoor tanning devices."
But the 25-member state cancer council, which is appointed by the governor and includes state agency officials, physicians and community leaders, voted unanimously Friday to amend the wording to reflect scientific evidence showing a link between indoor tanning and skin cancer.
The council voted unanimously to amend the consent form to read: "Indoor tanning can cause skin cancer. Skin cancer can be fatal. To reduce the risk of skin cancer, the American Academy of Pediatrics recommends that children under the age of 18 never use indoor tanning devices."
The revised wording is not meant to suggest that someone who uses an indoor tanning device surely will develop skin cancer, said Dr. William Nelson, director of Johns Hopkins' Sydney Kimmel Cancer Center and a council member.
"You're increasing the chances of getting cancer," Nelson said. "It's like saying that when you smoke a cigarette, you're increasing the chances of getting lung cancer."
Courtney Lewis, director of the health department's Center for Cancer Prevention and Control, said the panel wanted "parents to have the most accurate information about the risk with tanning, based on scientific evidence."
But members of the tanning industry argued that scientific evidence does not necessarily support a link between tanning devices and cancer.
"We believe in moderation. What we don't believe in is saying, unequivocally, that indoor tanning causes skin cancer. It is not proven," said Robin Eason, owner of Sunseekers Tanning Studios, a 30-year operation with locations in Bel Air, Baltimore and Crofton.
"Every tanning bed is regulated by the FDA," Eason said, "and the FDA says that 'this tanning bed with this combination of lights can only tan this skin type for this many minutes per session.' It's highly regulated."
Joe Levy, scientific adviser for the American Suntanning Association, said some researchers see no clear-cut relationship between skin cancer and UV exposure.
"There is no study model that has ever isolated nonburning UV exposure as an independent risk factor," Levy said.
Yasmine Kirkorian, a Johns Hopkins pediatric dermatology fellow, said that exposure to UV light in childhood and adolescence yields the highest skin cancer risk.
"In saying UV light can be harmful doesn't mean we recommend unrealistic living, like a hermit," Kirkorian said. "We become concerned when the length or extent of sun exposure damages the skin, and by definition that is always the case with UV exposure from indoor tanning."