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Motofei IG. Biology of cancer; from cellular and molecular mechanisms to developmental processes and adaptation. Semin Cancer Biol 2022; 86:600-615. [PMID: 34695580 DOI: 10.1016/j.semcancer.2021.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/21/2021] [Accepted: 10/10/2021] [Indexed: 02/07/2023]
Abstract
Cancer research has been largely focused on the cellular and molecular levels of investigation. Recent data show that not only the cell but also the extracellular matrix plays a major role in the progression of malignancy. In this way, the cells and the extracellular matrix create a specific local microenvironment that supports malignant development. At the same time, cancer implies a systemic evolution which is closely related to developmental processes and adaptation. Consequently, there is currently a real gap between the local investigation of cancer at the microenvironmental level, and the pathophysiological approach to cancer as a systemic disease. In fact, the cells and the matrix are not only complementary structures but also interdependent components that act synergistically. Such relationships lead to cell-matrix integration, a supracellular form of biological organization that supports tissue development. The emergence of this supracellular level of organization, as a structure, leads to the emergence of the supracellular control of proliferation, as a supracellular function. In humans, proliferation is generally involved in developmental processes and adaptation. These processes suppose a specific configuration at the systemic level, which generates high-order guidance for local supracellular control of proliferation. In conclusion, the supracellular control of proliferation act as an interface between the downstream level of cell division and differentiation, and upstream level of developmental processes and adaptation. Understanding these processes and their disorders is useful not only to complete the big picture of malignancy as a systemic disease, but also to open new treatment perspectives in the form of etiopathogenic (supracellular or informational) therapies.
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Affiliation(s)
- Ion G Motofei
- Department of Oncology/ Surgery, Carol Davila University, St. Pantelimon Hospital, Dionisie Lupu Street, No. 37, Bucharest, 020021, Romania.
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Harris HR, Korkes KMN, Li T, Kvaskoff M, Cho E, Carvalho LF, Qureshi AA, Abrao M, Missmer SA. Endometriosis, Psoriasis, and Psoriatic Arthritis: A Prospective Cohort Study. Am J Epidemiol 2022; 191:1050-1060. [PMID: 35029650 PMCID: PMC9393059 DOI: 10.1093/aje/kwac009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 01/16/2023] Open
Abstract
Endometriosis, psoriasis, and psoriatic arthritis (PsA) are chronic inflammatory disorders whose etiologies remain poorly understood but may be correlated, as endometriosis has been associated with other inflammatory disorders. We investigated the bidirectional associations between laparoscopically confirmed endometriosis and physician-diagnosed psoriasis and PsA in the Nurses' Health Study II cohort (n = 116,429, United States, 1991-2013). We confirmed 4,112 incident cases of laparoscopically confirmed endometriosis (mean age at diagnosis = 40.3 years) and 697 validated physician-diagnosed cases of psoriasis (mean age at diagnosis = 43.6 years), 110 of which presented with concomitant PsA. A history of psoriasis with concomitant PsA was associated with a 2-fold higher risk of endometriosis (hazard ratio (HR) = 2.01, 95% CI: 1.23, 3.30); however, no association was observed between psoriasis without PsA and endometriosis risk (HR = 0.93, 95% CI: 0.68, 1.26). When endometriosis was the exposure, it was not associated with a risk of subsequent psoriasis (HR = 1.28, 95% CI: 0.95, 1.72). The risk of psoriasis with PsA was notably higher; however, the sample size was small and the confidence intervals wide (HR = 1.77, 95% CI: 0.89, 3.52). Our findings suggest that psoriasis with concomitant PsA is associated with greater risk of laparoscopically confirmed endometriosis. In addition, there was a suggestive association between endometriosis diagnosis and subsequent risk of psoriasis with PsA.
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Affiliation(s)
- Holly R Harris
- Correspondence to Dr. Holly Harris, Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N., M4-B859, Seattle, WA 98109-1024 (e-mail: )
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Yang F, Mortlock S, MacGregor S, Iles MM, Landi MT, Shi J, Law MH, Montgomery GW. Genetic Relationship Between Endometriosis and Melanoma. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:711123. [PMID: 36304021 PMCID: PMC9580819 DOI: 10.3389/frph.2021.711123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
Epidemiological studies have observed that risk of endometriosis is associated with history of cutaneous melanoma and vice versa. Evidence for shared biological mechanisms between the two traits is limited. The aim of this study was to investigate the genetic correlation and causal relationship between endometriosis and melanoma. Summary statistics from genome-wide association meta-analyses (GWAS) for endometriosis and melanoma were used to estimate the genetic correlation between the traits and Mendelian randomization was used to test for a causal association. When using summary statistics from separate female and male melanoma cohorts we identified a significant positive genetic correlation between melanoma in females and endometriosis (rg = 0.144, se = 0.065, p = 0.025). However, we find no evidence of a correlation between endometriosis and melanoma in males or a combined melanoma dataset. Endometriosis was not genetically correlated with skin color, red hair, childhood sunburn occasions, ease of skin tanning, or nevus count suggesting that the correlation between endometriosis and melanoma in females is unlikely to be influenced by pigmentary traits. Mendelian Randomization analyses also provided evidence for a relationship between the genetic risk of melanoma in females and endometriosis. Colocalization analysis identified 27 genomic loci jointly associated with the two diseases regions that contain different causal variants influencing each trait independently. This study provides evidence of a small genetic correlation and relationship between the genetic risk of melanoma in females and endometriosis. Genetic risk does not equate to disease occurrence and differences in the pathogenesis and age of onset of both diseases means it is unlikely that occurrence of melanoma causes endometriosis. This study instead provides evidence that having an increased genetic risk for melanoma in females is related to increased risk of endometriosis. Larger GWAS studies with increased power will be required to further investigate these associations.
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Affiliation(s)
- Fei Yang
- The Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Sally Mortlock
- The Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- *Correspondence: Sally Mortlock
| | - Stuart MacGregor
- Statistical Genetics Group, Department of Genetics and Computational Biology, Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Mark M. Iles
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
- Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Matthew H. Law
- Statistical Genetics Group, Department of Genetics and Computational Biology, Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Health, and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Grant W. Montgomery
- The Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
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Chen ML, Wang SH, Wei JCC, Yip HT, Hung YM, Chang R. The Impact of Human Papillomavirus Infection on Skin Cancer: A Population-Based Cohort Study. Oncologist 2020; 26:e473-e483. [PMID: 33191546 DOI: 10.1002/onco.13593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study investigated the correlation between a history of human papillomavirus (HPV) infection and skin cancer risk. MATERIALS AND METHODS The study cohort comprised 26,919 patients with newly diagnosed HPV infection between 2000 and 2012; with the use of computer-generated numbers, patients without previous HPV infection were randomly selected as the comparison cohort. The patients in the HPV infection cohort were matched to comparison individuals at a 1:4 ratio by demographic characteristics and comorbidities. All study individuals were followed up until they developed skin cancer, withdrew from the National Health Insurance program, were lost to follow-up, or until the end of 2013. The primary outcome was subsequent skin cancer development. Cox proportional hazards regression analysis was used to analyze the risk of skin cancer with hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort. RESULTS The adjusted HR of skin cancer for patients with HPV relative to controls was 2.45 after adjusting sex, age and comorbidities. (95% CI, 1.44-4.18, p < .01). The subgroup analysis indicated that a patient with HPV infection had a significantly greater risk of skin cancer if they were aged >40 years. Notably, a risk of skin cancer was found in the group diagnosed with HPV within the first 5 years after the index date (adjusted HR, 3.12; with 95% CI, 1.58-5.54). Sensitivity analysis by propensity score, matching with balanced sex, age, and comorbidities, showed consistent results. CONCLUSION A history of HPV infection is associated with the development of subsequent skin cancer in Taiwanese subjects, and the risk wanes 5 years later. IMPLICATIONS FOR PRACTICE In this Taiwan nationwide cohort study, there was a 2.45-fold increased risk of developing new-onset skin cancers for patients with incident human papillomavirus (HPV) infection, compared with the matched controls. Furthermore, the risk was noticeably significant among patients aged >40 years. A prominent risk of skin cancers was found in the group diagnosed with HPV within the first 5 years after the index date in this study. The results of this analysis may raise consensus on the effect of HPV infection on the risk of skin cancers. Clinicians are encouraged to implement prudently on the differential diagnosis of skin cancers and HPV prevention and treatment, especially in older patients.
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Affiliation(s)
- Ming-Li Chen
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shuo-Hsuan Wang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Hei-Tung Yip
- Management office for Health Data, China Medical University, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,Institute of Public Health (Biostatistics), National Yangming University, Taiwan
| | - Yao-Min Hung
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.,Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,Tajen University, Pingtung, Taiwan
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Recreation Sports Management, Tajen University, Pingtung, Taiwan
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Cervenka I, Al Rahmoun M, Mahamat-Saleh Y, Savoye I, Boutron-Ruault MC, Fournier A, Kvaskoff M. Postmenopausal hormone use and cutaneous melanoma risk: A French prospective cohort study. Int J Cancer 2019; 145:1754-1767. [PMID: 30671928 DOI: 10.1002/ijc.32150] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/20/2018] [Accepted: 01/11/2019] [Indexed: 02/06/2023]
Abstract
Cutaneous melanoma has been suspected to be influenced by female hormones. Several studies reported a positive association between menopausal hormone therapy (MHT) use and melanoma risk; however, previous findings were conflicting. We sought to explore the associations between MHT use and melanoma risk in a prospective cohort of women in France, where a particularly wide variety of MHT formulations are available. E3N is a prospective cohort of 98,995 French women aged 40-65 years in 1990. MHT use was assessed through biennial self-administered questionnaires. We used Cox proportional hazards regression models adjusted for age and skin cancer risk factors. Over 1990-2008, 444 melanoma cases were ascertained among 75,523 postmenopausal women. Ever use of MHT was associated with a higher melanoma risk (hazard ratio (HR) = 1.35, 95% confidence intervals (CI) = 1.07-1.71). The association was strongest among past users (HR = 1.55, CI = 1.17-2.07, homogeneity for past vs. recent use: p = 0.11), and users of MHT containing norpregnane derivatives (HR = 1.59, CI = 1.11-2.27), although with no heterogeneity across types of MHT (p = 0.13). Among MHT users, the association was similar across durations of use. However, a higher risk was observed when treatment onset occurred shortly after menopause (<6 months: HR = 1.55, CI = 1.16-2.07 vs. ≥2 years). Associations between MHT use and melanoma risk were similar after adjustment for UV exposure, although MHT users were more likely to report sunscreen use than nonusers. Our data do not support a strong association between MHT use and melanoma risk. Further investigation is needed to explore potential effect modification by UV exposure on this relationship.
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Affiliation(s)
- I Cervenka
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94 805, Villejuif, France
- Gustave Roussy, F-94 805, Villejuif, France
| | - M Al Rahmoun
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94 805, Villejuif, France
- Gustave Roussy, F-94 805, Villejuif, France
| | - Y Mahamat-Saleh
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94 805, Villejuif, France
- Gustave Roussy, F-94 805, Villejuif, France
| | - I Savoye
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94 805, Villejuif, France
- Gustave Roussy, F-94 805, Villejuif, France
| | - M C Boutron-Ruault
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94 805, Villejuif, France
- Gustave Roussy, F-94 805, Villejuif, France
| | - A Fournier
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94 805, Villejuif, France
- Gustave Roussy, F-94 805, Villejuif, France
| | - M Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94 805, Villejuif, France
- Gustave Roussy, F-94 805, Villejuif, France
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Mahamat-Saleh Y, Cervenka I, Al Rahmoun M, Savoye I, Mancini FR, Trichopoulou A, Boutron-Ruault MC, Kvaskoff M. Mediterranean dietary pattern and skin cancer risk: A prospective cohort study in French women. Am J Clin Nutr 2019; 110:993-1002. [PMID: 31380561 DOI: 10.1093/ajcn/nqz173] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been reported to be associated with lower cancer risk. However, while previous studies explored major single components of the MD, only 1 previous study has investigated adherence to the MD in relation to melanoma risk. OBJECTIVE The aim of this study was to explore the relations between adherence to the MD and the risk of skin cancer, including melanomas, basal cell carcinomas (BCCs), and squamous cell carcinomas (SCCs). DESIGN Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a prospective cohort of 98,995 French women aged 40-65 y in 1990. Dietary data were collected via a validated food questionnaire in 1993. Adherence to the MD was assessed using a 9-unit dietary score that incorporates intakes of fruit, vegetables, legumes, cereal products, olive oil, fish, dairy products, meat products, and alcohol. We used Cox proportional hazards regression models to compute HRs and 95% CIs adjusted for age and main known skin cancer risk factors. RESULTS From 1993 to 2008, a total of 2003 skin cancer cases were ascertained among 67,332 women, including 404 melanomas, 1367 BCCs, and 232 SCCs. Score of adherence to the MD was associated with lower risk of skin cancer (HR: 0.83; 95% CI: 0.73, 0.93 for high compared with low score, Ptrend = 0.001). MD score was also inversely and linearly associated with risks of melanoma (HR: 0.72; 95% CI: 0.54, 0.96; Ptrend = 0.02) and BCC (HR: 0.77; 95% CI: 0.66, 0.90; Ptrend = 0.0006) but not SCC (HR: 1.08; 95% CI: 0.75, 1.55; Ptrend = 0.68), although with no heterogeneity across skin cancer types (Pheterogeneity = 0.23). CONCLUSION These findings suggest that adherence to the MD is associated with a lower skin cancer risk in women, particularly melanoma and BCC. If confirmed in future research, these findings may have important implications in skin cancer prevention.
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Affiliation(s)
- Yahya Mahamat-Saleh
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Iris Cervenka
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Marie Al Rahmoun
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Isabelle Savoye
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - Francesca Romana Mancini
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece.,WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Marie-Christine Boutron-Ruault
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Marina Kvaskoff
- Centre for Research in Epidemiology and Population Health (CESP) - School of Medicine, Université Paris Sud - School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ); INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
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Abstract
Epidermal cancers include keratinocyte cancer, melanocyte cancer, and Merkel cell carcinoma. These cancers account for the vast majority of new cancers diagnosed in Australia, North America, and Europe. Keratinocyte cancer is the most common epidermal cancer and accounts for 7 out of 8 new cancers diagnosed in Australia. Melanoma and Merkel cell carcinoma are less common than keratinocyte carcinoma but are more important causes of mortality in Australia. Keratinocyte cancer has also been demonstrated to be a marker of cancer-prone phenotype. Risk factors for epidermal cancer include intrinsic and environmental factors, in particular exposure to ultraviolet radiation and advanced age. Actinic keratosis has an approximate prevalence of 79% of men and 68% of women between 60 and 69 years of age, and has a low risk of malignant transformation into squamous cell carcinoma. Basal cell carcinoma is the most common malignancy in Caucasians worldwide, with the incidence increasing by 2% per year in Australia. Squamous cell carcinoma is the second most common epidermal cancer, with an incidence of approximately 1035 or 472 per 100,000 person-years in men and women, respectively. Primary risk factors for both basal cell carcinoma and squamous cell carcinoma include light skin color, UV radiation exposure, and chronic immunosuppression. Although the rate of melanoma is increasing, the mortality in Australia is reducing and is currently 9%. The overall incidence of melanoma in Australia is approximately 50 cases per 100,000 persons (62 for men and 40 for women). Keratinocyte carcinoma and melanoma are risk factors for developing further skin cancer and primary malignancy. This contribution reviews the incidence, prevalence, and risk factors associated with the development of epidermal cancer and premalignant epidermal neoplasia.
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Farland LV, Lorrain S, Missmer SA, Dartois L, Cervenka I, Savoye I, Mesrine S, Boutron-Ruault MC, Kvaskoff M. Endometriosis and the risk of skin cancer: a prospective cohort study. Cancer Causes Control 2017; 28:1011-1019. [PMID: 28799019 DOI: 10.1007/s10552-017-0939-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Endometriosis has been associated with an increased risk of skin melanoma. However, associations with other skin cancer types and how they compare with melanoma are unclear. Our objective was to prospectively investigate the relationships between endometriosis and risk of non-melanoma and melanoma skin cancers. METHODS E3N is a prospective cohort of 98,995 French women aged 40-65 years in 1990. Data on surgically confirmed endometriosis and skin cancer diagnoses were collected every 2-3 years through self-report, with skin cancer cases confirmed through pathology reports. Hazard Ratios (HR) and 95% confidence intervals (CIs) were calculated using Cox regression models. RESULTS Between 1990 and 2008, 535 melanoma, 247 squamous-cell carcinoma (SCC), and 1,712 basal-cell carcinoma (BCC) cases were ascertained. Endometriosis was associated with an increased overall risk of skin cancer (HR 1.28, 95% CI 1.05-1.55). When considering skin cancer type, endometriosis was associated with melanoma risk (HR 1.64, 95% CI 1.15-2.35), but not with SCC (HR 1.21, 95% CI 0.62-2.36) or BCC (HR 1.16, 95% CI 0.91-1.48) (non-melanoma skin cancers combined: HR 1.17, 95% CI 0.93-1.46), although no heterogeneity was detected across skin cancer types (Phomogeneity = 0.13). CONCLUSION These data support an association between a personal history of endometriosis and the risk of skin cancer and suggest that the association is strongest for melanoma.
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Affiliation(s)
- Leslie V Farland
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA.,Department of Obstetrics, Gynaecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Simon Lorrain
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, 33000, Bordeaux, France
| | - Stacey A Missmer
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA.,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, 02115, Boston, MA, USA.,Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, 49503, USA
| | - Laureen Dartois
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Iris Cervenka
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Isabelle Savoye
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Sylvie Mesrine
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France. .,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
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Santulli P, Marcellin L, Chouzenoux S, Boulard V, Just PA, Nicco C, Chereau C, Tosti C, Chapron C, Batteux F. Role of the protein kinase BRAF in the pathogenesis of endometriosis. Expert Opin Ther Targets 2016; 20:1017-29. [PMID: 27087167 DOI: 10.1080/14728222.2016.1180367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Mitogen-activated protein kinases (MAPKs) are involved in the proliferation and survival of endometriotic lesions. Vemurafenib (PLX4032) is a novel protein kinase inhibitor that targets BRAF, a member of the MAPK pathway. The present study tested the in vitro and in vivo effects of PLX4032 on endometriotic cells. RESEARCH DESIGN AND METHODS We conducted a laboratory study in a tertiary-care university hospital from January 2013 to September 2013. We enrolled a cohort of 40 patients: 20 with histologically proven endometriosis and 20 unaffected women. A thorough surgical examination of the abdominopelvic cavity was performed on all of the study participants. Ex vivo stromal and epithelial cells were extracted from endometrial and endometriotic biopsies from both sets of patients. Proliferation, apoptosis, pERK/ERK ratio, cell cycle regulation (Cyclin D1 and CDK4) and inflammation (PTGS2) were explored with and without PLX4032 treatment. Human endometriotic lesions were implanted into 40 nude mice that were separated into two groups according to PLX4032 or vehicle treatment, which they received for four weeks, before sacrifice and histological examination. RESULTS Treating endometriotic cells with PLX4032 abrogated the phosphorylation of ERK, significantly reducing the pERK/ERK ratio in both epithelial and stromal cells from endometriotic women compared to the controls (p < 0.05). In addition, treatment with PLX4032 significantly decreased proliferation in both stromal and epithelial cells with a concomitant decrease in Cyclin D1/CDK4 complex and PTGS2 levels. Using a murine model of endometriosis, we observed that PLX4032-treated mice displayed a significant decrease in implant volume compared to the initial size; a slight, but non-significant, increase in size was observed in the vehicle-treated mice. CONCLUSION Our data suggest that MAPKs and BRAF are involved in the pathogenesis of endometriosis. PLX4032-induced inhibition of BRAF controlled endometriotic growth, both in vitro and in vivo, and could constitute a promising target for the treatment of endometriosis.
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Affiliation(s)
- Pietro Santulli
- a Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine , Université Paris Descartes , Paris , France.,b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Louis Marcellin
- a Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine , Université Paris Descartes , Paris , France.,b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Sandrine Chouzenoux
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Veronique Boulard
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | | | - Carole Nicco
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Christiane Chereau
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Claudia Tosti
- d Obstetrics and Gynecology, Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Charles Chapron
- a Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine , Université Paris Descartes , Paris , France.,b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Frédéric Batteux
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France.,e Department of Immunology , Hôpital Cochin, AP-HP , Paris , France
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Kvaskoff M, Mu F, Terry KL, Harris HR, Poole EM, Farland L, Missmer SA. Endometriosis: a high-risk population for major chronic diseases? Hum Reprod Update 2015; 21:500-16. [PMID: 25765863 PMCID: PMC4463000 DOI: 10.1093/humupd/dmv013] [Citation(s) in RCA: 242] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/12/2015] [Accepted: 02/20/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities. METHODS We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches. RESULTS We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer. CONCLUSIONS Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If these relationships are confirmed, these findings may have important implications in screening practices and in the management and care of endometriosis patients.
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Affiliation(s)
- Marina Kvaskoff
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), 'Nutrition, Hormones and Women's Health' Team, F-94805 Villejuif, France Univ. Paris Sud 11, UMRS 1018, F-94807 Villejuif, France Gustave Roussy, F-94805 Villejuif, France Cancer Control Group, QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia
| | - Fan Mu
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - Kathryn L Terry
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Holly R Harris
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Division of Nutritional Epidemiology, The National Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Leslie Farland
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - Stacey A Missmer
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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12
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Xie J, Kvaskoff M, Li Y, Zhang M, Qureshi AA, Missmer SA, Han J. Severe teenage acne and risk of endometriosis. Hum Reprod 2014; 29:2592-9. [PMID: 25139175 DOI: 10.1093/humrep/deu207] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Is there a relationship between severe teenage acne and endometriosis? SUMMARY ANSWER Endometriosis is positively associated with severe teenage acne. WHAT IS KNOWN ALREADY No studies have specifically explored a possible association between severe acne in adolescence and risk of endometriosis. STUDY DESIGN, SIZE, DURATION This prospective cohort study used data collected from 88 623 female nurses from September 1989 to June 2009 as part of the Nurses' Health Study II (NHS II) cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS Regression models were used to calculate hazard ratios (HRs) and confidence intervals (CIs) for endometriosis among women with and without severe teenage acne. Multivariate models were adjusted for established risk factors of endometriosis. MAIN RESULTS AND THE ROLE OF CHANCE A total of 4 382 laparoscopically confirmed endometriosis cases were documented during 1 132 272 woman-years of follow-up. Compared with women without a history of severe teenage acne, women who had severe teenage acne had a 20% increased risk of endometriosis (HR = 1.20, 95% CI: 1.08-1.32). The association was not affected by adjusting for use of tetracycline or isotretinoin. LIMITATIONS AND REASONS FOR CAUTION The HR is likely to be underestimated since we only included endometriosis cases confirmed by laparoscopy. Although geographically diverse, the NHS II cohort is primarily Caucasian, which may limit generalization to more ethnically diverse populations. WIDER IMPLICATIONS OF THE STUDY The results of this study suggest that severe teenage acne is associated with an increased risk of endometriosis. As a visible and non-invasive clinical indicator, severe teenage acne may be useful for early detection of endometriosis. We bring this counter-intuitive association to the attention of clinicians for the benefit of the patient and an early diagnosis of endometriosis. STUDY FUNDING/COMPETING INTEREST This study was funded by research grant CA176726 from the National Institute of Health. M.K. is supported by a Marie Curie International Outgoing Fellowship within the 7th European Community Framework Programme (#PIOF-GA-2011-302078). The funding agencies had no role in the design of the study, in the analysis and interpretation of the data, in the writing of the report or in the decision to submit the paper for publication.
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Affiliation(s)
- Jing Xie
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Marina Kvaskoff
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Yunhui Li
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Mingfeng Zhang
- Clinical Research Program, Department of Dermatology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Abrar A Qureshi
- Clinical Research Program, Department of Dermatology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Stacey A Missmer
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jiali Han
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA Clinical Research Program, Department of Dermatology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, IN, USA
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13
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Kvaskoff M, Bijon A, Mesrine S, Vilier A, Baglietto L, Fournier A, Clavel-Chapelon F, Dossus L, Boutron-Ruault MC. Association between melanocytic nevi and risk of breast diseases: The French E3N prospective cohort. PLoS Med 2014; 11:e1001660. [PMID: 24915306 PMCID: PMC4051602 DOI: 10.1371/journal.pmed.1001660] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 04/30/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While melanocytic nevi have been associated with genetic factors and childhood sun exposure, several observations also suggest a potential hormonal influence on nevi. To test the hypothesis that nevi are associated with breast tumor risk, we explored the relationships between number of nevi and benign and malignant breast disease risk. METHODS AND FINDINGS We prospectively analyzed data from E3N, a cohort of French women aged 40-65 y at inclusion in 1990. Number of nevi was collected at inclusion. Hazard ratios (HRs) for breast cancer and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. Associations of number of nevi with personal history of benign breast disease (BBD) and family history of breast cancer were estimated using logistic regression. Over the period 15 June 1990-15 June 2008, 5,956 incident breast cancer cases (including 5,245 invasive tumors) were ascertained among 89,902 women. In models adjusted for age, education, and known breast cancer risk factors, women with "very many" nevi had a significantly higher breast cancer risk (HR = 1.13, 95% CI = 1.01-1.27 versus "none"; ptrend = 0.04), although significance was lost after adjustment for personal history of BBD or family history of breast cancer. The 10-y absolute risk of invasive breast cancer increased from 3,749 per 100,000 women without nevi to 4,124 (95% CI = 3,674-4,649) per 100,000 women with "very many" nevi. The association was restricted to premenopausal women (HR = 1.40, ptrend = 0.01), even after full adjustment (HR = 1.34, ptrend = 0.03; phomogeneity = 0.04), but did not differ according to breast cancer type or hormone receptor status. In addition, we observed significantly positive dose-response relationships between number of nevi and history of biopsy-confirmed BBD (n = 5,169; ptrend<0.0001) and family history of breast cancer in first-degree relatives (n = 7,472; ptrend = 0.0003). The main limitations of our study include self-report of number of nevi using a qualitative scale, and self-reported history of biopsied BBD. CONCLUSIONS Our findings suggest associations between number of nevi and the risk of premenopausal breast cancer, BBD, and family history of breast cancer. More research is warranted to elucidate these relationships and to understand their underlying mechanisms.
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Affiliation(s)
- Marina Kvaskoff
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- * E-mail:
| | - Anne Bijon
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Sylvie Mesrine
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Alice Vilier
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, Victoria, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Victoria, Australia
| | - Agnès Fournier
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Françoise Clavel-Chapelon
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Laure Dossus
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
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14
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Kvaskoff M, Han J, Qureshi AA, Missmer SA. Pigmentary traits, family history of melanoma and the risk of endometriosis: a cohort study of US women. Int J Epidemiol 2014; 43:255-63. [PMID: 24343850 PMCID: PMC3937978 DOI: 10.1093/ije/dyt235] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Endometriosis has been associated with a higher risk of cutaneous melanoma, but the mechanisms underlying this association are unknown.Some constitutional factors known to influence melanoma risk have been associated with endometriosis in some retrospective studies. However, prospective data are scarce, and more research is needed to confirm this potentially novel endometriosis risk profile. METHODS To investigate the relationships between pigmentary traits, family history of melanoma and endometriosis risk, we analysed data from the Nurses’ Health Study II, a cohort of 116 430 female US nurses aged 25–42 years at inclusion in 1989. Data were collected every 2 years with 20 years of follow-up for these analyses. We used Cox proportional hazards regression models to compute relative risks(RRs) and 95% confidence intervals (CIs). RESULTS During 1 212 499 woman-years of follow-up, 4763 cases of laparoscopically-confirmed endometriosis were reported among premenopausal Caucasian women. Endometriosis risk was increased with presence of naevi on the lower legs (RR=1.08, 95% CI=1.021.14) and higher level of skin’s burning reaction to sun exposure in childhood/adolescence (‘burn with blisters’: RR=1.20,95% CI=1.061.36) compared with ‘practically none’;P(trend)=0.0006) and family history of melanoma (RR=1.13, 95%CI=1.011.26). CONCLUSION This assessment reports modest associations between several pigmentary traits, family history of melanoma and endometriosis risk,corroborating the results from previous retrospective studies. Our findings call for further research to better understand the mechanisms under lying these associations.
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Affiliation(s)
- Marina Kvaskoff
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy,Villejuif, France, Université Paris Sud 11, UMRS 1018, Villejuif, France, Cancer Control Group, Queensland Institute of Medical Research, Herston, QLD, Australia, Department of Dermatology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA and Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jiali Han
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy,Villejuif, France, Université Paris Sud 11, UMRS 1018, Villejuif, France, Cancer Control Group, Queensland Institute of Medical Research, Herston, QLD, Australia, Department of Dermatology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA and Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Abrar A Qureshi
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy,Villejuif, France, Université Paris Sud 11, UMRS 1018, Villejuif, France, Cancer Control Group, Queensland Institute of Medical Research, Herston, QLD, Australia, Department of Dermatology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA and Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Stacey A Missmer
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy,Villejuif, France, Université Paris Sud 11, UMRS 1018, Villejuif, France, Cancer Control Group, Queensland Institute of Medical Research, Herston, QLD, Australia, Department of Dermatology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA and Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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15
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Gin TJ, Gin AD, Gin D, Pham A, Cahill J. Spontaneous cutaneous endometriosis of the umbilicus. Case Rep Dermatol 2013; 5:368-72. [PMID: 24516408 PMCID: PMC3919486 DOI: 10.1159/000357493] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Cutaneous endometriosis that arises de novo, without a prior history of surgery, is a rare phenomenon. The clinical diagnosis of cutaneous endometriosis remains challenging due to the variable clinical appearance and symptoms of the condition, and therefore must be considered in the differential diagnosis of any umbilical lesion. We report a 31-year-old woman who presented with spontaneous cutaneous endometriosis of the umbilicus.
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Affiliation(s)
- Thomas J Gin
- The Royal Melbourne Hospital, The Alfred Hospital, Parkville, Vic., Australia
| | - Alexander D Gin
- The Royal Melbourne Hospital, The Alfred Hospital, Parkville, Vic., Australia
| | - Douglas Gin
- Department of Dermatology, The Alfred Hospital, Parkville, Vic., Australia
| | - Alan Pham
- Department of Pathology, The Alfred Hospital, Parkville, Vic., Australia
| | - Jennifer Cahill
- Department of Dermatology, The Alfred Hospital, Parkville, Vic., Australia
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16
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17
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Kvaskoff M, Bijon A, Mesrine S, Boutron-Ruault MC, Clavel-Chapelon F. Cutaneous melanoma and endogenous hormonal factors: a large French prospective study. Am J Epidemiol 2011; 173:1192-202. [PMID: 21415032 DOI: 10.1093/aje/kwq503] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To assess the role of endogenous hormonal factors on melanoma, the authors conducted a prospective analysis of 91,972 French women, aged 40-65 years at inclusion into the Etude Epidémiologique auprès de femmes de l'Education Nationale (E3N) cohort. Between 1990 and 2005, 460 melanoma cases were ascertained. Relative risks and 95% confidence intervals were computed by using Cox proportional hazards regression models. Risks of melanoma were reduced in women with ≥ 15 years at menarche (relative risk (RR) = 0.67, 95% confidence interval (CI): 0.46, 0.97, compared with 13-14 years), irregular menstrual cycles (RR = 0.52, 95% CI: 0.31, 0.89, compared with regular cycles of 25-31 days), <48 years at natural menopause (RR = 0.70, 95% CI: 0.48, 1.02, compared with 48-51 years), and shorter ovulatory life (RR = 0.51, 95% CI: 0.28, 0.91, for <33 years compared with ≥ 39 years). Modest inverse associations were observed with parity, as well as number of pregnancies and miscarriages. There was no evidence of an association between melanoma risk and age at first birth or pregnancy, age at last birth, time since last birth, breastfeeding duration, age at menstruation regularity, or menopausal status. Results did not significantly differ according to ambient ultraviolet radiation dose and melanoma site or subtype. These findings from a large prospective cohort may suggest a reduced melanoma risk associated with decreased exposure to ovarian hormones.
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Affiliation(s)
- Marina Kvaskoff
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Nutrition, Hormones, and Women’s Health Team, Institut Gustave Roussy, Villejuif, France
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18
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Gemmill JAL, Stratton P, Cleary SD, Ballweg ML, Sinaii N. Cancers, infections, and endocrine diseases in women with endometriosis. Fertil Steril 2010; 94:1627-31. [PMID: 19945097 PMCID: PMC2946463 DOI: 10.1016/j.fertnstert.2009.07.1698] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 07/14/2009] [Accepted: 07/29/2009] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the prevalence of patient-reported, physician-diagnosed comorbid conditions in women with endometriosis. DESIGN Cross-sectional study of self-reported survey data. SETTING Academic research. PATIENT(S) Four thousand three hundred thirty-one Endometriosis Association (EA) members reporting surgically diagnosed endometriosis. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Self-reported, physician-diagnosed infectious diseases, cancers, and endocrine diseases. RESULT(S) Nearly two-thirds of women reported one or more of the assessed conditions. Recurrent upper respiratory infections and recurrent vaginal infections were common and more likely in women responding to the EA survey. Melanoma was reported by 0.7% (n=29), breast cancer by 0.4% (n=16), and ovarian cancer by 0.2% (n=10). While ovarian cancer and melanoma were significantly more common than in the general population, breast cancer was surprisingly less common. Addison's disease and Cushing's syndrome were rare (0.2% and 0.1%, respectively). CONCLUSION(S) Respondents reported a higher prevalence of recurrent upper respiratory or vaginal infections, melanoma, and ovarian cancer than the general population. These findings document other potential associations related to the immune system, which may help focus future research into this disease.
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Affiliation(s)
- Julie Anne L. Gemmill
- Program in Reproductive Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Pamela Stratton
- Program in Reproductive Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Sean D. Cleary
- Department of Epidemiology and Biostatistics, School of Public Health and Health Services, George Washington University, Washington, DC
| | - Mary Lou Ballweg
- Endometriosis Association International Headquarters, Milwaukee, Wisconsin
| | - Ninet Sinaii
- Program in Reproductive Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, Maryland
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Kvaskoff M, Bijon A, Mesrine S, Clavel-Chapelon F, Boutron-Ruault MC. Pigmentary traits and risk of endometriosis. Hum Reprod 2010; 25:3157-8; author reply 3158-9. [PMID: 20884667 DOI: 10.1093/humrep/deq250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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20
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Somigliana E, Viganò P, Abbiati A, Gentilini D, Parazzini F, Benaglia L, Vercellini P, Fedele L. 'Here comes the sun': pigmentary traits and sun habits in women with endometriosis. Hum Reprod 2010; 25:728-33. [PMID: 20083484 DOI: 10.1093/humrep/dep453] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is limited but interesting evidence suggesting that endometriosis may be associated with specific pigmentary traits and sun habits. In this case-control study, we aimed to further clarify this point. MATERIALS AND METHODS Consecutive patients with a first laparoscopic diagnosis of endometriosis according to Holt and Weiss criteria were selected as cases. Controls were women who underwent laparoscopy during the same study period, but who were found to be free of the disease. Selected women were interviewed and examined by two trained physicians. An unconditional logistic regression model that included age and baseline variables significantly differing between the two groups was used to estimate the adjusted odds ratios (OR). RESULTS There were 98 women with endometriosis and 94 controls selected. Overall, women with the disease had a more photo-sensitive phenotype and were exposed less to sun or ultraviolet radiation. A statistically significant difference was documented for eye color, skin reaction to first sun exposure, freckles score and the use of tanning creams. The adjusted OR (95% CI) for the disease was 1.95 (1.02-3.72) for women with green/blue eyes, 2.19 (1.12-4.28) for those who frequently/always had skin burn reaction to first sun exposure, 5.67 (1.98-16.24) for those with a higher number of freckles and 0.35 (0.15-0.85) for the use of tanning creams. CONCLUSIONS Women with endometriosis have a specific photo-sensitive phenotype and protect themselves more from the sun. This latter habit may be consequent to the former. We speculate that there is a shared genetic background between pigmentation and endometriosis.
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Affiliation(s)
- Edgardo Somigliana
- Department of Obstetrics, Gynecology and Neonatology, Fondazione Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena, Milan, Italy
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21
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Grant WB. On the roles of skin type and sun exposure in the risk of endometriosis and melanoma. Int J Epidemiol 2009; 40:513-4; author reply 515-6. [PMID: 19887511 DOI: 10.1093/ije/dyp324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Missmer SA. Commentary: Endometriosis--epidemiologic considerations for a potentially 'high-risk' population. Int J Epidemiol 2009; 38:1154-5. [PMID: 19617382 DOI: 10.1093/ije/dyp249] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Stacey A Missmer
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Kvaskoff M, Mesrine S, Clavel-Chapelon F, Boutron-Ruault MC. Endometriosis risk in relation to naevi, freckles and skin sensitivity to sun exposure: the French E3N cohort. Int J Epidemiol 2009; 38:1143-53. [PMID: 19351698 DOI: 10.1093/ije/dyp175] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Endometriosis is an important women's health issue, however its aetiology remains unknown. An association between endometriosis and cutaneous melanoma was described, possibly explained through common genetic features. To further investigate this association, we assessed the link between phenotypic traits predisposing to melanoma and the risk of endometriosis. METHODS Using a case-control design, we analysed data from 97,215 women of the Etude Epidémiologique auprès de femmes de l'Education Nationale study, a cohort of 98,995 French women insured by a national health scheme mostly covering teachers, and aged 40-65 years at inclusion in 1990. Risk estimates were computed using unconditional logistic regression models. RESULTS After adjustment for potential confounding factors, there was a positive dose-effect relationship between risk of endometriosis (reported as surgically ascertained, n = 4241) and skin sensitivity to sun exposure [moderate: odds ratio (OR) 1.09, 95% confidence interval (CI) 0.99-1.19; high: OR 1.22; 95% CI 1.10-1.36; compared with none; Ptrend < 0.0001], number of naevi (few: OR 1.19, 95% CI 1.05-1.35; many: OR 1.37, 95% CI 1.21-1.55; very many: OR 1.59, 95% CI 1.37-1.83; compared with none; Ptrend < 0.0001) and number of freckles (few: OR 1.08, 95% CI 1.00-1.17; very many/many: OR 1.11, 95% CI 1.03-1.20; compared with none; Ptrend = 0.005). CONCLUSION This study is, to our knowledge, the first to report a positive dose-effect relationship between the risk of endometriosis and skin sensitivity to sun exposure, and number of naevi and freckles. These data suggest that endometriosis and melanoma may share some genetic features.
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Affiliation(s)
- Marina Kvaskoff
- Inserm (Institut National de la Santé et de la Recherche Médicale) ERI 20, EA 4045 and Institut Gustave Roussy, Villejuif, France
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