Does hormone replacement therapy and use of oral contraceptives increase the risk of non-melanoma skin cancer?

Birch-Johansen, Fatima; Jensen, Allan; Olesen, Anne Braae; Christensen, Jane; Tjønneland, Anne; Kjær, Susanne K.

doi:10.1007/s10552-011-9887-4

Cited by 28 publications

(36 citation statements)

References 39 publications

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“…This study relied on self‐reported skin cancer diagnoses and hence lacked histologic information. In a Danish cohort, the reported relative risk was 1.35 for every 5 years of HRT exposure . We found a similarly increased risk specific to SCC, which appeared to be independent of prior exogenous hormone exposure as the risk was unchanged when excluding those with prior OC use.…”

Section: Discussionmentioning

confidence: 51%

“…Additionally, it relied on hospital referral codes rather than histologic diagnosis, leaving open the possibility of diagnostic misclassification and making BCC‐ and SCC‐specific risk calculations impossible. Additionally, a Danish cohort study, found no OC‐associated increased risk of SCC either overall or by duration or time since last use . This study likewise had limited statistical power due to the small number of SCC cases ( n = 76).…”

Section: Discussionmentioning

confidence: 85%

“…Nonetheless, while sex‐dependent steroids are known carcinogens for certain malignancies ( e.g . breast, uterine, and prostate carcinoma), relatively few studies have been conducted on keratinocyte cancers . These studies have found varying risks of KC associated with hormone exposure; however, interpretation of these results has been challenging due to limited statistical power, variation in analyses by duration and timing of exposure, and lack of comprehensive investigation of different forms of hormone exposure in a single population and across both SCC and BCC.…”

mentioning

confidence: 99%

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Sex hormones and the risk of keratinocyte cancers among women in the United States: A population‐based case–control study

Kuklinski

Zens

Perry

et al. 2016

Intl Journal of Cancer

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Men are at a higher risk of developing both squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) than women, but there is emerging evidence that women may be experiencing greater increases in the incidence rates of these malignancies than men. One possible explanation is the expanding use of sex steroids among women, although only a few studies have examined this hypothesis. As part of a population-based, case-control study of women in New Hampshire, USA, we sought to evaluate the risk of SCC, BCC, and early-onset BCC in relation to exogenous and endogenous sex hormones. We found that oral contraceptive (OC) use was associated with an increased risk of SCC (OR = 1.4, 95% CI = 1.1–1.8) and BCC (OR = 1.4, 95% CI = 1.0–1.8), particularly high estrogen dose (>50mg) OC use. Hormone replacement therapy (HRT) use also related to SCC, with an elevated OR largely for progestin use (OR = 1.4, 95% CI = 1.1–1.8). Additionally, both OC use and combination HRT use were associated with more aggressive BCC subtypes. In contrast, menstrual and reproductive history did not appear to influence keratinocyte cancer risk in our data. Our findings provide evidence that use of sex steroids may enhance risk of KC.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 85%

mentioning

confidence: 99%

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Sex hormones and the risk of keratinocyte cancers among women in the United States: A population‐based case–control study

Kuklinski

Zens

Perry

et al. 2016

Intl Journal of Cancer

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“…It is generally accepted that OCP consumption contributes to skin cancer (16). In a cohort study by Birch-Johansen et al on 29875 patients in Denmark between 1993-1997, it was demonstrated that the role of hormone replacement therapy (HRT) in developing NMSC is greater than OCP (17). The role of UV radiation from artificial sources, unlike studies carried out in other countries, was not considered as a predisposing factor (18) because of limited availability of equipment and also unpopularity of UV tanning beds or UV tanning salons among members of the Iranian population.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Study of Non-Melanoma Skin Cancers Qazvin Province, Iran

Beheshtiroy¹,

Hajmanoochehri²

2014

Biotech Health Sci

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Background: Non-melanoma skin cancers (NMSC) are the most common cancers worldwide. These cancers are not accompanied by high mortality however they lead to various complications. Evaluation of NMSC predisposing factors could result in preventive measures, improvement of quality of life and reduction of medical costs. Objectives: This study aimed to determine predisposing factors of non-melanoma skin cancers in the province of Qazvin (Iran). Materials and Methods: A total of 484 proven cases of NMSC were evaluated for demographic characteristics, clinical findings, pathological type, location of lesion, and the existence of known or possible predisposing factors such as skin type, exposure to sunlight, and family and drug history within a ten-year period from 2001 to 2011. Data were recorded in a questionnaire through interview and clinical examination of patients by a physician and a dermatologist, respectively. Data were analyzed using the SPSS version 16 software and statistical tests including t-test and chi-square tests. Results: Of the 484 patients, 294 (60.7%) were male and 190 (39.3%) were female. Most cases of carcinoma were found in basal cells (77.7%) and the rest of squamous cells. The most common sites of involvement were the head and scalp. The most frequent predisposing factors were working in the open air (70.7%), history of previous radiation for treatment of tenia capitis (26.1%), and chronic skin diseases such as burn eschar, chronic lesion, fistula and actinic keratosis (35.7%). The most prevalent Fitzpatrick skin phenotypes were II or III (75.4%). There were significant correlations between the incidence of NMSC and hookah smoking and oral contraceptive pill (OCP) consumption. Conclusions: Skin phenotypes II and III were the most common types found in the present study and this could be due to the higher frequency of these phenotypes among the study population. The lower incidence of NMSC in areas other than the neck and scalp could be associated with the importance of covering style used by the population under study. Known risk factors for the incidence of NMSC were also observed in the present study. A history of radiotherapy for treatment of tenia capitis was observed in a considerable percentage of patients, which could lead to the incidence of cancer several decades later. Further studies are needed to determine the role of hookah smoking and the use of OCP in the occurrence of NMSC.

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“…The findings for oral contraceptive use were null [43]. In another cohort study a similar association between menopausal hormonal therapy and BCC (ever-vs.-never use RR 1.15; 95% CL 1.02–1.29) was observed [44]. Results such as these raise the notion that menopausal estrogen exposures may have at least a modest deleterious impact on KC risk, but the evidence-base needs to be strengthened before firm conclusions can be reached.…”

Section: Individual Lifestyle Risk Factorsmentioning

confidence: 96%

Epidemiology of Keratinocyte Carcinoma

2017

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Purpose of the review To provide a synopsis of recent research advances in the epidemiology of keratinocyte carcinoma (KC), with a focus on indoor tanning and known risk factors for other forms of cancer such as cigarette smoking and alcohol drinking. Recent findings The evidence is strong enough to infer that use of UVR-emitting indoor tanning devices cause KC. Epidemiologic studies of cigarette smoking, alcohol drinking, and menopausal hormone therapy all show some suggestion for increased risk of KC but the evidence is not yet strong enough to determine if there is a true etiologic role. Body mass index is clearly inversely associated with KC risk but this is more likely to be due to lower UVR exposure in overweight and obese individuals than it is due to a true etiologic role. Summary The epidemic of KC continues unabated, and the causal role of indoor tanning is contributing to this unfavorable trend in KC incidence rates. Advances in understanding the etiology of KC should not divert attention away from the fact that the primary public health strategy to prevent KC is known: minimize population exposure to UVR from the sun and from UVR-emitting indoor tanning devices, particularly among those with sun-sensitive phenotypes.

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Does hormone replacement therapy and use of oral contraceptives increase the risk of non-melanoma skin cancer?

Abstract: The findings indicated that HRT but not OC may increase the risk of NMSC. However, further studies are warranted as risk estimates for SCC had relatively low precision due to a limited number of SCC cases.

Cited by 28 publications

References 39 publications

Sex hormones and the risk of keratinocyte cancers among women in the United States: A population‐based case–control study

Sex hormones and the risk of keratinocyte cancers among women in the United States: A population‐based case–control study

Epidemiological Study of Non-Melanoma Skin Cancers Qazvin Province, Iran

Epidemiology of Keratinocyte Carcinoma

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