Having Children, Social Characteristics, Smoking and the Risk of Uveal Melanoma: A Case-Control Study

Zinkhan, Melanie; Stang, Andreas; Jöckel, Karl‐Heinz; Marr, Anja; Bornfeld, Norbert; Schmidt‐Pokrzywniak, Andrea

doi:10.3109/09286586.2013.844842

Cited by 13 publications

(15 citation statements)

References 41 publications

(55 reference statements)

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“…30,31 However, another study reported increased uveal melanoma risk among women with children. 32 The lack of association with OCPs is consistent with other studies reporting no apparent relationship between OCPs and uveal melanoma metastases. 29,30,33 This analysis did not find any association between choroidal nevus and ever using any type of postmenopausal HRT, which is consistent with studies in the literature reporting no association between HRT and uveal melanoma.…”

Section: Discussionsupporting

confidence: 90%

Relationship Between Female Reproductive Factors and Choroidal Nevus in US Women

Qiu

Shields

2015

JAMA Ophthalmol

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IMPORTANCE Choroidal nevus is a precursor for uveal melanoma and there are no known risk factors besides white race. Female sex hormones have been hypothesized to play a role in the pathogenesis of uveal melanoma. OBJECTIVE To explore the association between female reproductive factors and choroidal nevus in the US adult female population. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based study of 2505 US women aged 40 years or older from the 2005-2008 National Health and Nutrition Examination Survey. The women completed the reproductive health questionnaire and underwent retinal imaging. The analysis was conducted in April 2015. EXPOSURES Age at menarche, oral contraceptive use, pregnancy, parity, age at first and last births, age at menopause, hysterectomy, oophorectomy, hormone therapy use, and body mass index (calculated as weight in kilograms divided by height in meters squared). MAIN OUTCOMES AND MEASURES Choroidal nevus on retinal imaging. RESULTS The mean age of participants was 56.5 years, and the racial/ethnic distribution was 76.9% white, 10.1% African American, 8.4% Hispanic, and 4.8% other. The weighted prevalence of choroidal nevus was 4.5%. Premenopausal women who first gave birth before age 20 years had more than 4 times higher odds of choroidal nevus than those who first gave birth after age 35 years (odds ratio [OR], 4.16; 95% CI, 1.29-13.45; P = .02), and premenopausal women who gave birth to their last child before age 25 years had nearly 5 times higher odds of choroidal nevus than those who gave birth to their last child after age 35 years (OR, 4.89; 95% CI, 1.15-20.74; P = .03). These relationships were independent of total parity and years between the first and last births. The odds of choroidal nevus in postmenopausal women who were overweight and obese were 2 times higher than in postmenopausal women with normal body mass index (OR, 2.11; 95% CI, 1.19-3.76; P = .01 for overweight and OR, 1.92; 95% CI, 1.13-3.25; P = .02 for obese). CONCLUSIONS AND RELEVANCE The association between choroidal nevus and earlier start and end to childbearing in premenopausal women and obesity in postmenopausal women suggests that this relationship could be partially mediated via increased total lifetime unopposed estrogen. Clinicians should have an increased index of suspicion for choroidal nevus and choroidal melanoma in this population.

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Section: Discussionsupporting

confidence: 90%

Relationship Between Female Reproductive Factors and Choroidal Nevus in US Women

Qiu

Shields

2015

JAMA Ophthalmol

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“…However, such protective effects are weak or insignificant 28 , 29 . Other studies did not confirm such association 30 , 31 or demonstrated tendencies toward smoking-related increased risks 10 , 32 . Thus, pathophysiological pathways underlying the relationship of smoking and melanoma currently poses a challenge in melanoma research 23 , 24 .…”

Section: Introductionmentioning

confidence: 84%

BsmI (rs1544410) and FokI (rs2228570) vitamin D receptor polymorphisms, smoking, and body mass index as risk factors of cutaneous malignant melanoma in northeast Italy

Cauci

Maione

Buligan

et al. 2017

Cancer Biology & Medicine

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Objective: To investigate whether vitamin D receptor gene (VDR) BsmI-rs1544410 and FokI-rs2228570 polymorphisms, smoking duration, and body mass index (BMI) are risk factors for cutaneous melanoma, especially metastatic melanoma. Methods: We studied 120 cutaneous melanoma cases [68 stage I and II non-metastatic melanoma (NMetM) patients, plus 52 Stage III and IV metastatic melanoma (MetM) patients], and 120 matching healthy controls from northeast Italy. VDR polymorphisms were measured by restriction fragment length polymorphism analysis. Absence or presence of BsmI and FokI restriction sites was denoted by " B” and " F” or by " b” and " f,” respectively. Results: VDR-BsmI bb genotype was more frequent among MetM (32.7%) than among NMetM cases (13.2%), with odds ratio (OR)=3.18. Comparison of all melanoma patients vs healthy controls showed that the following biomarkers were at risk: ≥20 years of smoking (OR=2.43); ≥20 years of smoking combined with bb (OR=4.78), Bb+bb (OR=2.30), Ff (OR=3.04), and Ff+ff (OR=3.08); obesity (BMI>30 kg/m2) alone (OR=3.54); and obesity combined with Bb+bb (OR=3.52), Ff (OR=4.78), and Ff+ff (OR=6.56). Comparison of MetM vs NMetM patients revealed that the following biomarkers were at risk: ≥20 years of smoking (OR=2.39), ≥20 years of smoking combined with bb (OR=5.13), Bb+bb (OR=3.07), and Ff+ff (OR=2.66); and obesity combined with Bb+bb (OR=5.27), Ff (OR=6.28), and Ff+ff (OR=9.18). Triple combination of ≥20 years of smoking, obesity, and Bb+bb yielded OR=9.65 for melanoma patients vs healthy controls and OR=12.2 for MetM vs. NMetM patients. Conclusions: Risk factors for cutaneous MetM include two VDR polymorphisms combined with smoking duration and obesity. Results suggest gene-environment implications in melanoma susceptibility and severity. Future studies in larger cohorts and in subjects with different genetic background are warranted to extend our findings.

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“…A Polish study assessed the influence of one's education on the recognition of second primary cancers in uveal melanoma patients revealing that those with secondary and higher education had significantly more frequent diagnoses of second primary cancers than those who had primary and vocational education [23]. Meanwhile, Zinkhan et al suggested that a higher socio-economic level is associated with a decreased risk for uveal melanoma [24]. Nevertheless, another German research group inferred that highest school degree or post-school professional degree and a two-dimensional social index show no association with uveal melanoma [25].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of uveal melanoma in Brazil

et al. 2020

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Purpose To report the prevalence of uveal melanoma in a Hospital database in Brazil over the period of 16 years (2000 to 2016). Design Descriptive epidemiological study evaluating the Brazilian Hospital Based Cancer Registries. Participants/methods Uveal melanomas were identified based on ICD-O-3 codes C69.3 [choroid], C69.4 [ciliary body and iris], and C69.2 [retina]) derived from the Integrator Registry database. Kolmogorov–Smirnov Test was used for evaluation of normality of data, t-test and Chi square were used for categorical and continuous variables respectively using SPSS Software. Main outcome measures Age, sex, education, regional distribution, clinical staging at the diagnosis, time from diagnosis to treatment (≤ 60 days versus > 60 days) and first-course therapy (surgery, chemotherapy, radiotherapy or a combination of such). Results There were 2166 cases of uveal melanoma representing 5.4% of all cases of melanoma. Histological confirmation of uveal melanoma was available in all cases. Higher prevalence of 1139 cases (52.6%) in women than 1027 cases (47.4%) in men was observed. Age distribution revealed 1411 cases (65.1%) in the group between 41 and 69 years old. A total of 429 (19.8%) patients were classified as initial disease and 334 (15.4%) as advanced (regional or distant metastases). Staging as initial disease was more frequent (113–24.8%) in patients with > 8 school years than in patients with < 8 school years (179–17.6%) reflecting disparities in healthcare access between those two populations. No difference was noticed in terms of diagnosis, staging and treatment after the Brazilian “60 days law” (Federal Law 12.732/12) came into effect in 2013 regulating the maximum period that a patient with cancer has to wait until start the treatment. Conclusion Epidemiological data is critical for planning early treatment strategies and allocating medical resources. This study intended to understand the characteristics of uveal melanoma in Brazil.

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Having Children, Social Characteristics, Smoking and the Risk of Uveal Melanoma: A Case-Control Study

Cited by 13 publications

References 41 publications

Relationship Between Female Reproductive Factors and Choroidal Nevus in US Women

Relationship Between Female Reproductive Factors and Choroidal Nevus in US Women

BsmI (rs1544410) and FokI (rs2228570) vitamin D receptor polymorphisms, smoking, and body mass index as risk factors of cutaneous malignant melanoma in northeast Italy

Epidemiology of uveal melanoma in Brazil

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