Does use of estrogens decrease the Breslow thickness of melanoma of the skin? Oral contraceptives and hormonal replacement therapy

Abstract

Recently, we showed there was a cumulative dose-dependent association between the use of estrogens and the incidence of cutaneous melanoma (CM). This association was shown for both oral contraceptives (OC) and hormonal replacement therapy (HRT). Some in-vitro studies, however, have suggested a direct inhibitory effect on melanoma tumor growth. Therefore, the use of different types of estrogens, OC and HRT, may be associated with a decreased Breslow thickness. Consequently, the clinical impact of our earlier findings may be limited. In this study, we investigated whether estrogen use (0.5 year), OC or HRT, is associated with a decreased Breslow thickness. For this study, we linked the national Dutch pathology database (PALGA) to a pharmacy database (PHARMO). Cases were women with a primary CM between 1 January 1991 and 14 December 2004, aged > or =18 years and having > or =3 years of follow-up before diagnosis of CM. In total, 687 women with melanoma were included. Univariable linear regression analysis suggested a decreased Breslow thickness with the use of OC and HRT. Statistically significant interaction was observed between age and estrogen use (P<0.01) suggesting effect modification by age. However, in stratified multivariable analyses for different age groups (<45, 45-55, > or =55 years), no statistically significant associations between the use of OC or HRT and Breslow thickness were observed. In conclusion, an association between use of OC and HRT and Breslow thickness could not be confirmed.

Melanoma Survival Disadvantage in Young, Non-Hispanic White Males Compared With Females

“…5 Evidence of a role of estrogen in melanoma development and progression has been inconsistent. 6,[35][36][37] Some findings have suggested that the balance of estrogen receptor α to estrogen receptor β may correlate with melanoma progression, 38 but a case series found no sex difference in estrogen receptor β expression in melanocytic nevi or melanomas. 39 In addition, a meta-analysis found no sex difference in the incidence of BRAF and NRAS mutations, which have been associated with cutaneous melanoma development.…”

Occurrence of Comorbidities before and after Soft Tissue Sarcoma Diagnosis

“…Records from PALGA were linked to the PHARMO record linkage system (PHARMO RLS). This linkage has been used in previous published studies [18, 19]. Data from the PHARMO RLS consist of multiple observational databases linked on a patient level, covering 3 million inhabitants of geographic defined areas in the Netherlands.…”

Review Is oestrogen an important player in melanoma progression?

“…Koomen et al . [ 68 ] showed that there is no such statistically significant association; however, decreased Breslow thickness among women using oestrogen, especially among older women, has not been excluded [ 68 ]. The results of Tang et al .…”