American Journal of Epidemiology Advance Access originally published online on December 8, 2006
American Journal of Epidemiology 2007 165(5):505-513; doi:10.1093/aje/kwk040
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ORIGINAL CONTRIBUTIONS |
Reproductive Risk Factors for Cutaneous Melanoma in Women: A Case-Control Study
1 Statistics and Epidemiology Program, Research Triangle Institute International, Research Triangle Park, NC
2 Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
3 Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
4 Division of Endocrinology and Metabolism, Department of Medicine, University of California San Francisco, San Francisco, CA
5 Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
6 Pigmented Lesion Study Group, School of Medicine, University of Pennsylvania, Philadelphia, PA
7 Dermatology Section, Memorial Sloan-Kettering Cancer Center, New York, NY
8 Melanoma Clinic, University of California San Francisco, San Francisco, CA
Correspondence to Dr. Margaret Tucker, Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, EPS7122, Rockville, MD 20892-7236 (e-mail: tuckerp{at}mail.nih.gov).
Received for publication April 15, 2006. Accepted for publication July 26, 2006.
Reproductive hormonal factors may have a potential role in cutaneous melanoma. This study estimated the risk of melanoma in women related to self-reported changes in nevi during pregnancy, while using oral contraceptives and/or hormone replacement therapy. Trained interviewers administered a questionnaire obtaining information about oral contraceptive use, hormone replacement therapy, reproductive history, sun exposure, occupation, and medical history from 318 Caucasian women newly diagnosed between 1991 and 1992 from two pigmented lesion clinics in San Francisco, California, and Philadelphia, Pennsylvania. A total of 395 frequency-matched control participants were recruited from hospital-affiliated outpatient clinics. Clinicians conducted skin examinations to assess the number and type of nevi, extent of freckling, solar damage, and skin type. For women aged less than 55 years, there was an association between a livebirth 5 years before diagnosis (odds ratio = 2.6, 95% confidence interval: 1.3, 5.3) and between number of births and melanoma risk (for 
3 births: odds ratio = 3.3, 95% confidence interval: 1.7, 6.5; ptrend < 0.001). Changes in nevi during recent pregnancies were a risk factor for melanoma, based upon small numbers (odds ratio = 2.9, 95% confidence interval: 1.1, 8.1). Oral contraceptive use and hormone replacement therapy were not associated with melanoma risk.
case-control studies; contraceptives, oral; hormone replacement therapy; melanoma; nevus, pigmented; parity
Abbreviations: HRT, hormone replacement therapy; OC, oral contraceptive
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