HORMONAL AND REPRODUCTIVE INFLUENCES AND RISK OF MELANOMA IN WOMEN

Background Evidence linking female hormones to the development of mali gnant melanoma has been contradictory. The purpose of this study was t o examine the risk of melanoma in relation to exogenous and endogenous hormonal variables in women, including oral contraceptives, replaceme nt oestrogens, pregnancy, and menopause. Methods Hormonal and reproduc tive factors were evaluated using data from a personal-interview popul ation-based case-control study of melanoma in women conducted in Conne cticut during 1987-1989. Caucasian female incident invasive melanoma c ases (n = 308) were confirmed by standardized histopathological review . Caucasian female controls (n = 233) were selected by random digit di alling and frequency-matched on age. Data were analysed using multivar iate logistic regression. Results Ever being pregnant, age at first pr egnancy, current use of replacement oestrogens, ever use of oral contr aceptives, duration of use of oral contraceptives, and age at first us e of oral contraceptives were not associated with melanoma. Among othe r variables, cases were more than twice as likely as controls to repor t a single pregnancy lasting >6 months, but this association lacked a dose-response relationship. Menopause and body mass index were not ind ependently associated with risk of melanoma. However, this analysis di d suggest that menopause and body mass index may be interactive risk f actors. Melanoma cases were three times more likely than controls to b e obese and report natural menopause when compared to thin/acceptable premenopausal women (OR = 3.00, 95% CI: 1.03-8.73). Conclusions These data do not provide strong evidence that hormonal and reproductive fac tors are associated with risk of melanoma in women, although the few p ositive results should be explored further.