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Int J Cancer. 2017 Nov 1;141(9):1763-1770. doi: 10.1002/ijc.30878. Epub 2017 Jul 19.

Menopausal hormone therapy and risk of melanoma: Do estrogens and progestins have a different role?

Author information

1
National Advisory Unit for Women's Health, Women's Clinic, Oslo University Hospital, Oslo, Norway.
2
Department of Bowel Cancer Screening, Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway.
3
Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway.
4
Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway.
5
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
6
Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo, Norway.
7
Department of Mammography Screening, Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway.
8
Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway.
9
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
10
Department of Preventive Medicine, University of Southern California, Los Angeles, CA.
11
Department of Research, Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway.
12
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.
13
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
14
Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland.

Abstract

The association between use of menopausal hormone therapy (HT) and occurrence of skin malignant melanoma (SMM) is controversial. We investigated the issue in a nationwide cohort of 684,696 Norwegian women, aged 45-79 years, followed from 2004 to 2008. The study was based on linkage between Norwegian population registries. Multivariable Poisson regression models were used to estimate the effect of HT use, different HT types, routes of administration and doses of estrogen and progestin on the risk of SMM. During the median follow-up of 4.8 years, 178,307 (26%) women used HT, and 1,476 incident SMM cases were identified. Current use of HT was associated with increased risk of SMM (rate ratios (RR) = 1.19; 95% confidence interval (CI) 1.03-1.37). Plain estrogen therapy was associated with an increased risk of SMM (RR 1.45; 95% CI 1.21-1.73), both for oral (RR 1.45; 95% CI 1.09-1.93) and vaginal (RR 1.44; 95% CI 1.14-1.84) formulations, while combined estrogen and progestin therapy (EPT) was not (RR 0.91; 95% CI 0.70-1.19). We performed a dose-response analysis of estrogen and progestin in women using tablets, and found that use of estrogens was associated with increased risk (RR 1.24; 95% CI 1.00-1.53 per 1 mg/day) and use of progestins with decreased risk (RR 0.71; 95% CI 0.57-0.89 per 10 mg/month) of SMM. In conclusion, estrogens were associated with increased risk of SMM, while combinations of estrogens and progestins were not. Our results suggest that estrogens and progestins might affect the risk of SMM in opposite ways.

KEYWORDS:

estrogen; hormone therapy; menopause; progestin; skin malignant melanoma

PMID:
28685818
DOI:
10.1002/ijc.30878
[Indexed for MEDLINE]

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