A pooled analysis of 10 case–control studies of melanoma and oral contraceptive use

Abstract

Data regarding the effects of oral contraceptive use on women's risk of melanoma have been difficult to resolve. We undertook a pooled analysis of all case -control studies of melanoma in women completed as of July 1994 for which electronic data were available on oral contraceptive use along with other melanoma risk factors such as hair colour, sun sensitivity, family history of melanoma and sun exposure. Using the original data from each investigation (a total of 2391 cases and 3199 controls), we combined the study-specific odds ratios and standard errors to obtain a pooled estimate that incorporates inter-study heterogeneity. Overall, we observed no excess risk associated with oral contraceptive use for 1 year or longer compared to never use or use for less than 1 year (pooled odds ratio (pOR)=0.86; 95% CI=0.74 -1.01), and there was no evidence of heterogeneity between studies. We found no relation between melanoma incidence and duration of oral contraceptive use, age began, year of use, years since first use or last use, or specifically current oral contraceptive use. In aggregate, our findings do not suggest a major role of oral contraceptive use on women's risk of melanoma.

Anthropometric factors and risk of melanoma in women: A pooled analysis

“…34 Whenever possible we used standardized groupings. 34,43,44 Described in detail in an earlier report, 34 questions relating to sun exposure history varied considerably across studies. Therefore, we included the sunlight-related factors most strongly related to melanoma risk within each study.…”

“…These variables included history of sunburns, sun exposure and migration to Australia. 34 All estimates were age-adjusted. To assess the impact of other potentially confounding factors, we examined the percent change in the age-adjusted pOR with the addition of each factor.…”

“…33,34 Strict criteria were used to minimize inter-study heterogeneity and ensure comparable study quality. Briefly, we analyzed studies completed as of July 1994 that included melanomas diagnosed both on an inpatient and outpatient basis, collected data through a personal interview on important risk factors for melanoma (i.e., pigmentary traits and sun exposure history), and included at least 100 women with melanoma and 100 women controls.…”

Melanoma in pregnancy – where we are?

“…A WHO study found a statistically increased tumor thickness in pregnant women versus non-pregnant controls, despite finding no impact of pregnancy on MM outcome [10]. Furthermore, a large population-based study found no significant difference in MM tumor thickness in pregnancy [11] and melanoma in pregnancy survival study showed the same [12]. Overall, there is little evidence to support that physiologic changes of pregnancy significantly affect the histopathology of MM.…”

“…Large-scale studies involving thousands of women have shown no significant correlation between localized melanoma diagnosis made during pregnancy and survival [11,12]. Some studies have shown a shortened disease-free interval in patients diagnosed in pregnancy, while other larger studies have shown no correlation.…”