Tattoos and risk of cutaneous melanoma and nonmelanoma skin cancer in France.

BACKGROUND

With the increasing popularity of decorative tattooing, which entails the intradermal injection of inks that may contain carcinogens, investigating the related potential skin cancer risk is a public health priority.

METHODS

We used data from the Cancer Risk Attributable with the Body Art of Tattooing study, nested in the French national cohort Consultants des Centres d'Examens de Santé (adults aged 18-69 years recruited in 2012-2018). Tattoo exposure was collected in 2020-2023. Skin cancers overall, cutaneous melanoma, and nonmelanoma skin cancer diagnosed during 2007-2021 were retrieved from national health insurance data. As exposure was collected after possible disease ascertainment, risks of skin cancer with prior tattoo exposure were assessed using logistic regression and Cox proportional hazards models in a retrospective cohort design.

RESULTS

Among 111 074 participants, 1789 (1.6%) skin cancers were recorded (693 cutaneous melanoma, 1096 nonmelanoma skin cancer). No association was found between binary tattoo exposure (yes, no) and any skin cancer type. In the highest exposure category of tattoo body surface (>2 hand palms), 2 participants with skin cancer were observed among 1633 (0.1%) participants, yielding an odds ratio of 0.21 for overall skin cancer (95% confidence interval [CI] = 0.05 to 0.83; reference no tattoos); however, the corresponding Cox model was not statistically significant (hazard ratio [HR] = 0.26, 95% CI = 0.07 to 1.05).

CONCLUSIONS

No overall association between tattoo exposure and skin cancer was observed. The inverse association in the highest exposure category is based on very few skin cancer diagnoses and should be interpreted with caution. Further studies with larger number of participants with skin cancer more detailed exposure assessment are warranted.