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Exogenous hormone use and cutaneous melanoma risk in women: The European Prospective Investigation into Cancer and Nutrition |
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| Authors: | Iris Cervenka Marie Al Rahmoun Yahya Mahamat-Saleh Agnès Fournier Marie-Christine Boutron-Ruault Gianluca Severi Saverio Caini Domenico Palli Reza Ghiasvand Marit B Veierod Edoardo Botteri Anne Tjønneland Anja Olsen Renée T Fortner Rudolf Kaaks Matthias B Schulze Salvatore Panico Antonia Trichopoulou Clio Dessinioti Katerina Niforou Sabina Sieri Rosario Tumino Carlotta Sacerdote Bas Bueno-de-Mesquita Torkjel M Sandanger Sandra Colorado-Yohar Maria J Sánchez Leire Gil Majuelo Leila Lujan-Barroso Eva Ardanaz Susana Merino Karolin Isaksson Salma Butt Ingrid Ljuslinder Malin Jansson Ruth C Travis Kay-Tee Khaw Elisabete Weiderpass Laure Dossus Sabina Rinaldi Marina Kvaskoff |
| Institution: | 1. CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine – UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
Gustave Roussy, Villejuif, France;2. CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine – UVSQ, INSERM, Université Paris-Saclay, Villejuif, France;3. Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research, Prevention and Oncology Network Institute (ISPRO), Florence, Italy;4. Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway;5. Department of Bowel Cancer Screening, Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway;6. Danish Cancer Society Research Center, Copenhagen, Denmark University of Copenhagen, Copenhagen, Denmark;7. Danish Cancer Society Research Center, Copenhagen, Denmark;8. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany;9. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany;10. Dipartimento di medicina clinica e chirurgia, Federico II University, Naples, Italy;11. Hellenic Health Foundation, Athens, Greece;12. Hellenic Health Foundation, Athens, Greece 1st Department of Dermatology Andreas Syggros Hospital University of Athens, Athens, Greece;13. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Via Venezian, Milan, Italy;14. Cancer Registry and Histopathology Department, Azienda Sanitaria Provinciale (ASP), Ragusa, Italy;15. Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy;16. Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;17. Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway;18. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellin, Colombia;19. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Andalusian School of Public Health, Biomedical Research Institute ibs.GRANADA, University of Granada, Granada, Spain;20. Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Ministry of Health of the Basque Government, San Sebastian, Spain;21. Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Gran Via de L'Hospitalet, Barcelona, Spain;22. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Navarra Public Health Institute, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, Pamplona, Spain;23. Public Health Directorate, Asturias, Spain;24. Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital, Lund, Sweden;25. Department of Radiation Sciences, Oncology, Norrlands University Hospital, Umeå, Sweden;26. Department of Surgery and Perioperative Sciences/Surgery, Umeå University, Umeå, Sweden;27. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom;28. University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom;29. International Agency for Research on Cancer, Lyon, France;30. Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France |
| Abstract: | Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country-specific self-administered questionnaires. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Over 1992–2015, 1,696 melanoma cases were identified among 334,483 women, whereof 770 cases among 134,758 postmenopausal women. There was a positive, borderline-significant association between OC use and melanoma risk (HR = 1.12, 95% CI = 1.00–1.26), with no detected heterogeneity across countries (phomogeneity = 0.42). This risk increased linearly with duration of use (ptrend = 0.01). Among postmenopausal women, ever use of MHT was associated with a nonsignificant increase in melanoma risk overall (HR = 1.14, 95% CI = 0.97–1.43), which was heterogeneous across countries (phomogeneity = 0.05). Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations. |
| Keywords: | cohort studies cutaneous melanoma epidemiology hormonal treatments menopausal hormone therapy oral contraceptives |