Cancer Epidemiology · Oct 27, 2026

A policy evaluation of Australia's commercial solarium ban: A 14-year regression discontinuity analysis of melanoma incidence, mortality and clinical severity

By Tohan MM, Mahumud RA

BACKGROUND: Australia prohibited commercial solariums in 2015 to reduce exposure to artificial ultraviolet (UV) radiation, an established and preventable cause of melanoma. However, evidence of population-level effects on melanoma incidence, mortality, and clinical severity remains limited. OBJECTIVE: To evaluate whether the commercial solarium ban was associated with immediate and longer-term changes in melanoma incidence, mortality, and clinical severity nationally and across states and demographic, geographic, and tumour-thickness subgroups. METHODS: We conducted a quasi-experimental regression discontinuity study using three population-based datasets from the Australian Institute of Health and Welfare. Analyses examined national melanoma incidence (1982-2021), mortality (1971-2021), state-specific trends across six states accounting for Western Australia's 2016 implementation, and clinical severity using Breslow thickness and other histopathological indicators. Parametric ordinary least squares models with heteroskedasticity-robust standard errors were complemented by non-parametric local polynomial analyses. Robustness was assessed using alternative bandwidths, kernel specifications, and placebo cutoffs. RESULTS: At the national level, the commercial solarium ban was associated with an estimated immediate reduction of 3.86 melanoma cases per 100,000 population and 2.28 melanoma deaths per 100,000 population. However, neither reduction was statistically significant (p = 0.493 and p = 0.171, respectively). Following the ban, the annual incidence trend decreased by 2.00 cases per 100,000 among males (p < 0.001) and by 3.62 cases per 100,000 among adults aged 60-69 years (p < 0.001). In the same age group, the annual mortality trend decreased by 0.59 deaths per 100,000 (p < 0.001). Declining incidence trends were also observed for thin melanomas (≤1 mm) and intermediate-thickness melanomas (>2-4 mm), while melanomas thicker > 4 mm exhibited an immediate reduction following the ban. Queensland and Western Australia experienced declining incidence trends, with a corresponding decline in mortality trends in Western Australia. CONCLUSION: The ban was not associated with an abrupt nationwide reduction in melanoma incidence or mortality but coincided with improvements in selected demographic, geographic, and tumour-thickness groups. These heterogeneous patterns suggest a potential gradual policy effect rather than an immediate population-wide decline.

doi.org/10.1016/j.canep.2026.103265PubMed 42945764Industry & policy