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Hormone therapy and melanoma in women. Int J Womens Dermatol 2022; 7:692-696. [PMID: 35028367 PMCID: PMC8714603 DOI: 10.1016/j.ijwd.2021.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/01/2021] [Accepted: 06/22/2021] [Indexed: 11/20/2022] Open
Abstract
Melanocytes are known to respond to estrogen stimulation. Knowledge of estrogen therapy in melanoma tumor behavior is essential to inform accurate patient prognostication. There is limited evidence to suggest oral contraception and fertility treatments affect melanoma incidence. The effect of menopausal hormone therapy on melanoma risk requires further investigation with multinational studies.
Although primary cutaneous melanoma accounts for approximately 3% of all malignant skin tumors, it has the greatest contribution to skin cancer–related death. Sex-specific differences in melanoma tumor behavior have been described, and melanoma pathogenesis may be hormonally mediated. This review aims to summarize the literature to date regarding the effects of hormone therapy on melanoma in women. Women's exogenous hormone use has changed dramatically over the past few decades. Thus, we focus on studies investigating the associations between oral contraception, fertility treatments, menopausal hormone therapy (MHT), and melanoma. Across hormone therapy types, there does not appear to be a well-established association between exogenous female hormones and melanoma incidence. However, MHT practices and formulations vary significantly across countries. Although MHT does not appear to increase melanoma risk in studies from the United States, conflicting results have been observed in Europe. Unopposed estrogen MHT formulations require further investigation to determine a clear pattern between hormone use and the development of melanoma.
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Freund L, Kjær SK, Guleria S, Albieri V, Nybo Andersen AM, Frederiksen K, Jensen A. Use of Fertility Drugs and Risk of Malignant Melanoma: Results from a Large Danish Population-Based Cohort Study. J Invest Dermatol 2021; 141:2189-2196.e1. [PMID: 33741390 DOI: 10.1016/j.jid.2021.02.752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 02/04/2021] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
Fertility drugs have not definitively been linked to malignant melanoma. By the use of data from a large nationwide cohort of women aged 20.0-45.0 years and living in Denmark between January 1, 1995 and December 31, 2011, we assessed the association between the use of fertility drugs and the risk of malignant melanoma. Information on fertility status and the use of fertility drugs was obtained from the population-based Danish Infertility Cohort. Cox proportional hazard regression models were applied to estimate hazard ratios and 95% confidence intervals with adjustment for potential confounders. The study population comprised 1,330,954 women, of whom 86,231 (6.5%) were treated with fertility drugs. During a median follow-up of 21.0 years, 6,139 women were diagnosed with malignant melanoma. Compared with fertile women, women with fertility challenges who had used any fertility drugs had an increased risk of malignant melanoma (hazard ratio = 1.14; 95% confidence interval = 1.02-1.27). Furthermore, the use of specific types of fertility drugs (clomiphene, gonadotropins, human chorionic gonadotropin, gonadotropin-releasing hormone preparations, and progesterone) was also associated with an increased risk of malignant melanoma, with hazard ratios ranging between 1.09 and 1.13; however, the association did not reach statistical significance. Our findings indicate that the use of fertility drugs was associated with a modestly increased risk of malignant melanoma.
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Affiliation(s)
- Linn Freund
- Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjær
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sonia Guleria
- Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vanna Albieri
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten Frederiksen
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Allan Jensen
- Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
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Salliot C, Nguyen Y, Gusto G, Gelot A, Gambaretti J, Mariette X, Boutron-Ruault MC, Seror R. Female hormonal exposures and risk of rheumatoid arthritis in the French E3N-EPIC cohort study. Rheumatology (Oxford) 2021; 60:4790-4800. [PMID: 33547777 DOI: 10.1093/rheumatology/keab101] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/08/2020] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To assess the relationships between female hormonal exposures and risk of RA in a prospective cohort of French women. METHODS E3N (Etude Epidémiologique auprès des femmes de la Mutuelle générale de l'Education Nationale) is an on-going French prospective cohort that included 98 995 women aged 40-65 years in 1990. Every 2-3 years, women completed mailed questionnaires on their lifestyles, reproductive factors and health conditions. Cox proportional hazards regression models were used to determine factors associated with risk of incident RA, with age as the time scale, adjusted for known risk factors of RA, and considering endogenous and exogenous hormonal factors. Hazard ratios (HRs) and 95% CIs were estimated. Effect modification by smoking history was investigated. RESULTS A total of 698 incident cases of RA were ascertained among 78 452 women. In multivariable-adjusted Cox regression models, risk of RA was increased with early age at first pregnancy (<22 vs ≥27 years; HR = 1.34; 95% CI 1.0, 1.7) and menopause (≤45 vs ≥53 years; HR = 1.40; 95% CI 1.0, 1.9). For early menopause, the association was of similar magnitude in ever and never smokers, although the association was statistically significant only in ever smokers (HR = 1.54; 95% CI 1.0, 2.3). We found a decreased risk in nulliparous women never exposed to smoking (HR = 0.44; 95% CI 0.2, 0.8). Risk of RA was inversely associated with exposure to progestogen only in perimenopause (>24 vs 0 months; multi-adjusted HR = 0.77; 95% CI 0.6, 0.9). CONCLUSIONS These results suggest an effect of both endogenous and exogenous hormonal exposures on RA risk and phenotype that deserves further investigation.
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Affiliation(s)
- Carine Salliot
- Center for Research in Epidemiology and Population Health (CESP), Institut Pour la Santé et la Recherche Médicale (INSERM) U1018, Université Paris-Saclay, Villejuif.,Rheumatology Department, Centre Hospitalier Régional d'Orléans, Orléans.,Center of Immunology of Viral Infections and Auto-immune Diseases (IMVA), Institut Pour la Santé et la Recherche Médicale (INSERM) U1184, Université Paris-Saclay, Paris
| | - Yann Nguyen
- Center for Research in Epidemiology and Population Health (CESP), Institut Pour la Santé et la Recherche Médicale (INSERM) U1018, Université Paris-Saclay, Villejuif.,Department of Internal Medicine, AP-HP.Nord, Hôpital Beaujon, Université de Paris, Clichy
| | - Gaëlle Gusto
- Center for Research in Epidemiology and Population Health (CESP), Institut Pour la Santé et la Recherche Médicale (INSERM) U1018, Université Paris-Saclay, Villejuif.,Institut Gustave Roussy, Université Paris-Saclay, Villejuif
| | - Amandine Gelot
- Center for Research in Epidemiology and Population Health (CESP), Institut Pour la Santé et la Recherche Médicale (INSERM) U1018, Université Paris-Saclay, Villejuif.,Institut Gustave Roussy, Université Paris-Saclay, Villejuif
| | - Juliette Gambaretti
- Center for Research in Epidemiology and Population Health (CESP), Institut Pour la Santé et la Recherche Médicale (INSERM) U1018, Université Paris-Saclay, Villejuif.,Institut Gustave Roussy, Université Paris-Saclay, Villejuif
| | - Xavier Mariette
- Center of Immunology of Viral Infections and Auto-immune Diseases (IMVA), Institut Pour la Santé et la Recherche Médicale (INSERM) U1184, Université Paris-Saclay, Paris.,Rheumatology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), AP-HP, Université Paris-Saclay-Hôpital Bicêtre, Paris, France
| | - Marie-Christine Boutron-Ruault
- Center for Research in Epidemiology and Population Health (CESP), Institut Pour la Santé et la Recherche Médicale (INSERM) U1018, Université Paris-Saclay, Villejuif.,Institut Gustave Roussy, Université Paris-Saclay, Villejuif
| | - Raphaèle Seror
- Center of Immunology of Viral Infections and Auto-immune Diseases (IMVA), Institut Pour la Santé et la Recherche Médicale (INSERM) U1184, Université Paris-Saclay, Paris.,Rheumatology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), AP-HP, Université Paris-Saclay-Hôpital Bicêtre, Paris, France
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