Malignant melanoma risk after exposure to fertility drugs: results from a large Danish cohort study

Hannibal, Charlotte Gerd; Jensen, Allan; Sharif, Heidi; Kjær, Susanne K.

doi:10.1007/s10552-008-9138-5

Cited by 41 publications

(34 citation statements)

References 31 publications

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“…This explanation seems less plausible than an explanation based on hormonal factors [44]. It is also possible that this is simply a chance finding, although one other group [21] found that exposure to fertility drugs commonly used in IVF (follicle-stimulating hormone, human menopausal gonadotropin and gonadotropin-releasing hormone) was associated with a two-to three-fold increase in the risk of melanoma in parous but not nulliparous women.…”

Section: Discussionmentioning

confidence: 97%

“…A number of studies [17][18][19][20][21][22][23][24][25][26] have examined the association between fertility drug use and melanoma. Most had only small numbers of melanoma cases and most found no association between the two.…”

Section: Introductionmentioning

confidence: 99%

“…Most had only small numbers of melanoma cases and most found no association between the two. Of the two larger studies, one, with a total of 42 cases, found an increased risk with clomiphene use in nulliparous women [26], and the other, with 112 cases, found an increased risk with specific fertility drugs in parous women [21]. The only study that directly addressed in-vitro fertilization (IVF) was carried out in Australia [25], but this was limited in terms of having only 16 cases of melanoma in the cohort.…”

Section: Introductionmentioning

confidence: 99%

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Association between in-vitro fertilization, birth and melanoma

Stewart¹,

Holman²,

Finn³

et al. 2013

Melanoma Research

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A link between reproductive hormones and melanoma has long been suspected, and has been examined for numerous hormonal exposures, but the association between in-vitro fertilization (IVF) and melanoma has not been studied in depth. We used whole-population linked hospital and registry data to carry out a cohort study of women aged 20-44 years seeking hospital investigation and treatment for infertility in Western Australia from 1982 to 2002 with follow-up to 2010. The cohort comprised a total of 21 604 women followed for an average of 17.2 years. Of these, 7524 had IVF treatment, 14 870 gave birth and 149 women were diagnosed with an incident invasive melanoma. Using Cox regression analysis, we estimated hazard ratios (HRs) for melanoma associated with IVF and parity. Women who had IVF and gave birth had an increased rate of invasive melanoma compared with women who had IVF and remained nulliparous (HR 3.61; 95% confidence interval 1.79-7.26). There was little or no increase in the rate of invasive melanoma associated with giving birth in women who had non-IVF infertility treatment (HR 1.39; 95% confidence interval 0.88-2.20). These results suggest an association between reproductive factors and melanoma in the subgroup of women undergoing IVF treatment.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between in-vitro fertilization, birth and melanoma

Stewart¹,

Holman²,

Finn³

et al. 2013

Melanoma Research

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“…30 Briefly, the cohort comprised women with infertility referred to all Danish hospitals or private infertility clinics during 1963-98. In addition we included all women with a diagnosis of infertility (codes 628 and DN97, international classification of diseases, eighth and 10th revisions, respectively) recorded in the national patient registry, a nationwide register of virtually all discharges for somatic conditions from Danish hospitals since 1977.…”

Section: Methodsmentioning

confidence: 99%

Use of Fertility Drugs and Risk of Ovarian Cancer: Danish Population Based Cohort Study

Jensen

Sharif²,

Frederiksen³

et al. 2009

Obstetrical &Amp; Gynecological Survey

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Objective To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. Design Population based cohort study. Setting Danish hospitals and private fertility clinics. Participants 54 362 women with infertility problems referred to all Danish fertility clinics during 1963-98. The median age at first evaluation of infertility was 30 years (range 16-55 years), and the median age at the end of follow-up was 47 (range 18-81) years. Included in the analysis were 156 women with invasive epithelial ovarian cancer (cases) and 1241 subcohort members identified in the cohort during follow-up in 2006. Main outcome measure Effect of four groups of fertility drugs (gonadotrophins, clomifene citrate, human chorionic gonadotrophin, and gonadotrophin releasing hormone) on overall risk of ovarian cancer after adjustment for potential confounding factors. Results Analyses within cohort showed no overall increased risk of ovarian cancer after any use of gonadotrophins (rate ratio 0.83, 95% confidence interval 0.50 to 1.37), clomifene (1.14, 0.79 to 1.64), human chorionic gonadotrophin (0.89, 0.62 to 1.29), or gonadotrophin releasing hormone (0.80, 0.42 to 1.51). Furthermore, no associations were found between all four groups of fertility drugs and number of cycles of use, length of follow-up, or parity. Conclusion No convincing association was found between use of fertility drugs and risk of ovarian cancer.

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“…49 Ovarian cancer in infertile women vs general population: SIR: 1.09; 95% CI: 0.30-1.60) Ovarian cancer in women exposed to fertility meds vs general population: SIR: 0.68; 95% CI: 0.01-3.80 [25] Venn et al (1995) Cohort of infertile women 1978-1992;…”

Section: Infertile Womenmentioning

confidence: 99%

Fertility medications and the risk of cancer

Kovács

2013

Expert Review of Endocrinology & Metabolism

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Cancer is among the leading causes of death in all age groups for both sexes. Cancer is the second leading cause of death in women and is responsible for 22.1% of mortality [1]. Breast, lung and colorectal cancers are the three most common malignancies in women. Cancers of the reproductive organs are among the most frequently diagnosed malignant diseases (breast cancer is the most common, uterine cancer is the fourth and ovarian cancer is the eighth most common) [2].Multiple factors play a role in the etiology of cancer (genetic, infectious, environmental, life style, hormonal, and so on). Certain types of cancers are more common among women (e.g., thyroid), which suggests a role for hormonal effects. Reproductive factors that are also closely associated with alterations in the hormonal balance are also well known to be associated with certain malignancies. The use of hormone products to manage infertility of different etiologies have been available for approximately 50 years. The peak incidence for cancers of the reproductive organs is the fifth to sixth decade of life and therefore most patients who were exposed to these medications have recently entered menopause, or will do so in the near future. Due to the recent trend of delaying childbearing, the number of couples seeking infertility care is continuously on the rise. This has led to increased utilization of infertility services. It is therefore very important to study any potential association between these medications and cancer.This review will summarize the findings of large, relevant case-control and cohort studies and reviews that explored the association between infertility, fertility medication use and the subsequent risk of developing cancer. Studies that were published between 1976 and 2012 were considered for the review. They were identified through searching PubMed and by checking the reference lists of the individual articles. Studies with relatively large sample size, long follow-up times, a clear description of how the cancer cases were identified and with the proper selection of controls were considered for this review. The following search terms were used: in vitro fertilization (IVF), infertility, subfertility, cancer, ovarian cancer, breast cancer, uterine cancer, thyroid cancer, childhood cancer, fertility medication and gonadotropin.In case-control studies, the cases are first identified based on preset criteria (i.e., those individuals who have the disorder, in this case cancer). Controls are selected to match the cases for personal, geographic, period of time characteristics and so on. Proper control selection is important to establish a relationship between the studied exposure (in this case, fertility medication use) and the disorder. In this case, the researcher looks backward to identify whether cases or controls differ regarding their exposure Cancer is among the leading causes of death, and malignant diseases of the female genital tract are among the most common sites. Reproductive factors that are also associated with infertili...

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Malignant melanoma risk after exposure to fertility drugs: results from a large Danish cohort study

Abstract: Our findings showed no strong association between malignant melanoma risk and use of fertility drugs, although the results indicated that use of gonadotrophins or GnRH might increase risk in parous women. Longer follow-up is needed to confirm our findings.

Cited by 41 publications

References 31 publications

Association between in-vitro fertilization, birth and melanoma

Association between in-vitro fertilization, birth and melanoma

Use of Fertility Drugs and Risk of Ovarian Cancer: Danish Population Based Cohort Study

Fertility medications and the risk of cancer

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