The relation between cutaneous malignant melanoma (MM) and the use of oral contraceptives (OC) was investigated in a case-control study carried out from 1979 to 1991 among patients in hospitals and clinics in the Philadelphia (PA) and New York City (NY) metropolitan areas (United States). Cases were 615 women under age 70 who recently had been diagnosed with invasive melanoma; controls were 2,107 women of the same ages who had been treated for other conditions unrelated either to OC use or to skin diseases. The cases were categorized as severe or nonsevere based on the depth of invasion of the tumor or the presence or absence of metastases. Among the severe cases, OC use was not associated with MM: the relative risk (RR) estimate for ever-use was 1.1 (95 percent confidence interval [CI]=0.8–1.5) and the estimate for 10 or more years of use was 1.1 (CI=0.6–2.1). Nor was risk associated with recent use, long latency, or young age at first use. Among the nonsevere cases, ever-use of oral contraceptives was associated positively with MM (RR=1.5, CI=1.1–2.4) but there was no trend with increased duration of use. The findings provide evidence against the hypothesis that OC use increases the risk of malignant melanoma. The elevated estimates among the nonsevere cases most likely reflect selection bias rather than a causal relation.
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Boyle P, Robertson C. Age-period-cohort modeling of malignant melanoma in Scotland: epidemiologic implications (Abstract). Am J Epidemiol 1987; 126: 766.
Snell RS, Bischitz PG. The effect of large doses of estrogen and progesterone on melanin pigmentation. J Invest Dermatol 1960; 35: 73–82.
Sanchez NP, Mathak MA, Sato S, et al. Melasma: a clinical, light microscopic ultrastructural and immunofluorescence study. J Am Acad Dermatol 1981; 4: 698–710.
Holly EA. Melanoma and pregnancy. In: Gallagher RP, ed.. Recent Results in Cancer Research: Epidemiology of Malignant Melanoma. Berlin: Springer-Verlag, 1986; 118–26.
Beral V, Ramcharan S, Faris R. Malignant melanoma and oral contraceptive use among women in California. Br J Cancer 1977; 36: 804–9.
Adam SA, Sheaves JK, Wright NH, Mosser RN, Vessey MP. A case-control study of the possible association between oral contraceptives and malignant melanoma. Br J Cancer 1981; 44: 45–50.
Bain C, Hennekens CH, Speizer FE, Rosner B, Willett W, Belanger C. Oral contraceptive use and malignant melanoma. JNCI 1982; 68: 537–9.
Holly EA, Weiss NS, Liff JM. Cutaneous melanoma in relation to exogenous hormones and reproductive factors. JNCI 1983; 70: 827–31.
Holman CDJ, Armstrong BK, Heenan PJ. Cutaneous malignant melanoma in women: exogenous sex hormones and reproductive factors. Br J Cancer 1984; 50: 673–80.
Beral V, Evans S, Shaw H, Milton G. Oral contraceptive use and malignant melanoma in Australia. Br J Cancer 1984; 50: 681–5.
Helmrich SP, Rosenberg L, Kaufman DW, et al. Lack of an elevated risk of malignant melanoma in relation to oral contraceptive use. JNCI 1984; 72: 617–20.
Green A, Bain C. Hormonal factors and melanoma in women. Med J Aust 1985; 142: 446–8.
Gallagher RP, Elwood JM, Hill GB, Coldman AJ, Threlfall WJ, Spinelli JJ. Reproductive factors, oral contraceptive and risk of malignant melanoma: Western Canada Melanoma Study. Br J Cancer 1985; 52: 901–7.
Osterlind A, Tucker MA, Stone BJ, Jensen OM. The Danish case-control study of cutaneous malignant melanoma. III. Hormonal and reproductive factors in women. Int J Cancer 1988; 42: 821–4.
Hannaford PC, Villard-MacKintosh L, Vessey MP, et al. Oral contraceptives and malignant melanoma. Br J Cancer 1991; 63: 430–3.
Zanetti R, Francheschi S, Rosso S, et al. Cutaneous malignant melanoma in females: the role of hormonal and reproductive factors. Int J Epidemiol 1990; 3: 522–6.
Lê MG, Cabanes PA, Desrignes V, Chanteau MF, Mlika N, Avril MF. Oral contraceptive use and risk of cutaneous malignant melanoma in a case-control study of French women. Cancer Causes Control 1992; 3: 199–205.
Francheschi S, Barón AE, LaVecchia C. The influence of female hormones on malignant melanoma. Tumori 1990; 76: 439–49.
Green A. Oral contraceptives and skin neoplasia. Contraception 1991; 43: 653–66.
Slone D, Shapiro S, Miettinen OS. Case-control surveillance of serious illnesses atributable to ambulatory drug use. In: Colombo F, Shapiro S, Slone D, et al., eds. Epidemiological Evaluation of Drugs. Amsterdam: Elsevier North-Holland Inc., 1977; 59–82.
Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies. JNCI 1959; 22: 719–48.
Schlesselman JJ. Case-control Studies: Design, Conduct, Analysis. New York: Oxford University Press, 1982.
Potter JD, McMichael AJ. Large bowel cancer in women in relation to reproductive and hormonal factors: a case-control study. JNCI 1983; 71: 703–9.
Howe GR, Craib KJP, Miller AB. Age at first pregnancy and risk of colorectal cancer: a case-control study. JNCI 1985; 74: 1155–9.
Lee JAH. Melanoma and exposure to sunlight. Epidemiol Rev 1982; 4: 110–33.
Graham S, Marshall J, Haughey B, et al. An inquiry into the epidemiology of melanoma. Am J Epidemiol 1985; 122: 606–19.
Evans RD, Kopf AW, Lew RA, et al. Risk factors for the development of malignant melanoma. I. Review of case-control studies. J Dermatol Surg Oncol 1988; 14: 393–408.
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This research was supported in part by the US National Cancer Institute (grant R01 CA 45762). Additional support was provided by the US Food and Drug Administration (FD-U-000082); the views expressed do not necessarily represent the views of the Food and Drug Administration. The Slone Epidemiology Unit receives general support from Hoffmann-LaRoche, Inc. and Marion-Merrell Dow, Inc.
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Palmer, J.R., Rosenberg, L., Strom, B.L. et al. Oral contraceptive use and risk of cutaneous malignant melanoma. Cancer Causes Control 3, 547–554 (1992). https://doi.org/10.1007/BF00052752
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DOI: https://doi.org/10.1007/BF00052752