Cutaneous malignant melanoma in women: exogenous sex hormones and reproductive factors

Abstract

Summary The roles of exogenous sex hormones and reproductive factors in the causation of malignant melanoma of the skin in women were examined in a case-control study of 276 patients and 276 matched controls in Western Australia. There was no consistent evidence of a relationship between the incidence rates of different histogenetic types of melanoma and age at menarche, duration of menstrual life, degree of obesity, number of pregnancies more than 20 weeks in duration or use of oral contraceptive preparations (OCP). Exposure to OCP was examined separately for different age periods and in different intervals of time before diagnosis; no consistent trend emerged. There was borderline evidence of an association of superficial spreading melanoma with duration of use of unopposed oestrogens. On the basis of seven studies of the relationship of melanoma to OCP published to date, we estimate that the total incidence rate of melanoma in OCP ever-users is unlikely to be increased by more than one third the rate in never-users.

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

“…We cannot exclude the possibility that our findings are due to differences in average height by country, although this is unlikely as the majority of the studies included in the pooled analyses were conducted in North America and studies in other parts of the world have also observed associations with height. 5,7,18 The lack of association between BMI or weight and melanoma risk in our pooled analyses is consistent with the findings of 5 5,10,12,15,16 of 8 other case-control studies, [5][6][7]10,12,13,15,16 and 7 17-23 of 8 cohort studies. [17][18][19][20][21][22][23][24] To our knowledge there are no previous studies that have examined the association between weight gain and risk of melanoma among women.…”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Interpretation of the results has been hampered by differences in methodology and inconsistent approaches to defining overweight and obesity. Moreover, only a few studies have examined associations according to histologic subtype 14,15,25 or menopausal status, 7,8 which may be important given the possible link between reproductive and hormonal factors and risk of melanoma in women. 6,14,[26][27][28][29][30][31] The prevalence of overweight and obesity is growing dramatically in most parts of the world, and generally is higher in women than in men.…”

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

“…Eleven case -control studies met the analysis criteria (Beral et al, 1984;Holman et al, 1984;Gallagher et al, 1985;Green and Bain, 1985;Østerlind et al, 1988;Swerdlow et al, 1986;Elwood et al, 1990;Zanetti et al, 1990;Kirkpatrick et al, 1994;Langholz et al, 2000) and data were available for all but one of these (Beral et al, 1984). The investigators from all of the remaining studies agreed to take part.…”

“…The shape of the age incidence curve for melanoma resembles that of breast cancer and suggests a possible role of sex steroids and reproductive factors in the pathogenesis of both of these tumours. Indeed, women with a history of breast cancer appear to be at increased risk of melanoma and vice Gallagher et al, 1985;Green and Bain, 1985;Holly et al, 1995;Holman et al, 1984;Kirkpatrick et al, 1994;Langholz et al, 2000;Østerlind et al, 1988 andZanetti et al, 1990. versa (Schoenberg and Christine, 1980). Increased pigmentation, melanocytic proliferation, and tumour growth have been observed following oestrogen (and to a lesser extent progesterone) administration in experimental laboratory animals (Snell and Bischitz, 1960;Lopez et al, 1978).…”

“…However, these findings were based on a relatively small number of cases, and another cohort study found no excess risk (Adam et al, 1981). Subsequent case -control and cohort studies (Bain et al, 1982;Holly et al, 1983Holly et al, , 1995Holman et al, 1984;Helmrich et al, 1984;Beral et al, 1984;Gallagher et al, 1985;Green and Bain, 1985;Østerlind et al, 1988;Zanetti et al, 1990;Hannaford et al, 1991;Le et al, 1992;Palmer et al, 1992;Westerdahl et al, 1996;Gefeller et al, 1998;Smith et al, 1998;Feskanich et al, 1999) provided little evidence of an overall excess risk among ever users compared to never users, but a possible increase among long-term users (summarised in (Prentice and Thomas, 1987)). More recently, data from the Nurse's Health Studies indicated a risk of melanoma related to duration of oral contraceptive use, but only among current users (Feskanich et al, 1999).…”