Reproductive factors, exogenous hormone use and incidence of melanoma among women in the United States.
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ABSTRACT: Background
Although the photosensitising effects of oestrogens may increase the impact of ultraviolet radiation (UVR) on melanoma risk, few prospective studies have comprehensively assessed the association between oestrogen-related factors and melanoma.Methods
We examined the associations between reproductive factors, exogenous oestrogen use and first primary invasive melanoma among 167 503 non-Hispanic white, postmenopausal women in the NIH-AARP Diet and Health Study. Satellite-based ambient UVR estimates were linked to geocoded residential locations of participants at study baseline.Results
Increased risk of melanoma was associated with early age at menarche (≤10 vs ≥15 years: HR = 1.25, 95% CI: 0.92, 1.71; P for trend = 0.04) and late age at menopause (≥50 vs <45 years: HR = 1.34, 95% CI: 1.13, 1.59; P for trend = 0.001). The relationship between ambient UVR and melanoma risk was highest among women with age at menarche ≤10 years (HR per UVR quartile increase = 1.29; 95% CI: 1.05, 1.58; P-interaction = 0.02). Melanoma risk was not associated with parity, age at first birth, use of oral contraceptives or use of menopausal hormone therapy.Conclusions
Our findings suggest that increased melanoma risk is associated with early age at menarche and late age at menopause. Effect modification findings support the hypothesis that endogenous oestrogen exposure in childhood increases photocarcinogenicity. Future studies should include information on personal UVR exposure and sun sensitivity.
SUBMITTER: Donley GM
PROVIDER: S-EPMC6461881 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundHepatocellular carcinoma (HCC) occurs less commonly among women than men in almost all regions of the world. The disparity in risk is particularly notable prior to menopause suggesting that hormonal exposures during reproductive life may be protective. Exogenous oestrogenic exposures such as oral contraceptives (OCs), however, have been reported to increase risk, suggesting that estrogens may be hepatocarcinogenic. To examine the effects of reproductive factors and exogenous hormones on risk, we conducted a prospective analysis among a large group of US women.MethodsIn the Liver Cancer Pooling Project, a consortium of US-based cohort studies, data from 799,500 women in 11 cohorts were pooled and harmonised. Cox proportional hazards regression models were used to generate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of reproductive factors and exogenous hormones with HCC (n=248).ResultsBilateral oophorectomy was associated with a significantly increased risk of HCC (HR=2.67, 95% CI=1.22-5.85), which did not appear to be related to a shorter duration of exposure to endogenous hormones or to menopausal hormone therapy use. There was no association between OC use and HCC (HR=1.12, 95% CI=0.82-1.55). Nor were there associations with parity, age at first birth, age at natural menopause, or duration of fertility.ConclusionsThe current study suggests that bilateral oophorectomy increases the risk of HCC but the explanation for the association is unclear. There was no association between OC use and HCC risk. Examination of endogenous hormone levels in relation to HCC may help to clarify the findings of the current study.
| S-EPMC4385955 | biostudies-literature
Project description:BACKGROUND AND OBJECTIVE: A number of studies have focused on the association between oral contraceptive (OC), hormonal replacement therapy (HRT) and reproductive factors and meningioma risk, but the results were inconsistent. Thus, a meta-analysis was performed to obtain more precise estimates of risk. METHODS: We conducted a literature search using PubMed and EMBASE databases to July 2013, without any limitations. Random effects models were used to summarize results. RESULTS: Twelve case-control and six cohort studies were included in this meta-analysis. We found that an increased risk of meningioma was associated with HRT use(RR = 1.19, 95% CI = 1.01-1.40), postmenopausal women(RR = 1.32, 95% CI = 1.07-1.64) and parity(RR = 1.18, 95% CI = 1.00-1.40).No significant associations were observed for OC use (RR = 0.93, 95% CI = 0.83-1.03), age at menarche(RR = 1.06, 95% CI = 0.92-1.21), age at menopause(RR = 1.03, 95% CI = 0.81-1.30), or age at first birth(RR = 0.94, 95% CI = 0.80-1.10). CONCLUSION: In conclusion, the results of our study support the hypothesis that longer exposure to effect of female sex hormones may increase the risk of meningioma in women, yet additional studies are warranted to confirm our findings and identify the underlying biological mechanisms.
| S-EPMC3873952 | biostudies-literature
Project description:Female sex hormones are known to have immunomodulatory effects. Therefore, reproductive factors and exogenous hormone use could influence the risk of multiple myeloma in women. However, the role of hormonal factors in multiple myeloma etiology remains unclear because previous investigations were underpowered to detect modest associations.We conducted a pooled analysis of seven case-control studies included in the International Multiple Myeloma Consortium, with individual data on reproductive factors and exogenous hormone use from 1,072 female cases and 3,541 female controls. Study-specific odds ratios and corresponding 95% confidence intervals (CI) were estimated using logistic regression and pooled analyses were conducted using random effects meta-analyses.Multiple myeloma was not associated with reproductive factors, including ever parous [OR = 0.92; 95% confidence interval (CI), 0.68-1.25], or with hormonal contraception use (OR = 1.04; 95% CI, 0.80-1.36). Postmenopausal hormone therapy users had nonsignificantly reduced risks of multiple myeloma compared with never users, but this association differed across centers (OR = 0.65; 95% CI, 0.37-1.15, I(2) = 76.0%, Pheterogeneity = 0.01).These data do not support a role for reproductive factors or exogenous hormones in myelomagenesis.Incidence rates of multiple myeloma are higher in men than in women, and sex hormones could influence this pattern. Associations with reproductive factors and exogenous hormone use were inconclusive despite our large sample size, suggesting that female sex hormones may not play a significant role in multiple myeloma etiology.
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Project description:BACKGROUND:In this study of cannabis use in large nationally representative samples of United States (US) women aged 12-44?years, we evaluate variation by pregnancy month and by trimester. We also evaluate cannabis dependence, which might explain why some women continue using cannabis during pregnancy. METHODS:Large nationally representative samples drawn for the US National Surveys on Drug Use and Health included 12-44-year-old women asked about pregnancy month, cannabis use, and cannabis dependence (n?=?381,199). For this research, we produced month-specific estimates across four-time intervals (2002-2005, 2006-2009, 2010-2013, 2014-2017). RESULTS:Overall from 2002 to 2017, estimates for non-pregnant women and for pregnant women in Trimester 1 indicate 7%-8% had used cannabis at least once in the 30?days prior to assessment. For pregnancy Month 1, the corresponding estimate is 11%, double Month 3 estimate of 5%. This degree of month-to-month variation is not seen for pregnant women in Trimesters 2 and 3, for whom estimates are 3% and 2%, respectively. Among women using cannabis during pregnancy, an estimated 19% have cannabis dependence, versus an expected value of 13% among non-pregnant women (p?<?.05). CONCLUSION:Evidence of a possibly ameliorative pregnancy-associated reduction of cannabis use prevalence was seen by Month 3 during pregnancy. Cannabis dependence may help account for cannabis use early during pregnancy. Identification and outreach to reproductive age women with cannabis dependence might decrease prenatal cannabis exposure.
| S-EPMC6791768 | biostudies-literature
Project description:ObjectiveTo examine current levels, correlates of, and changes in contraceptive use among reproductive-age women in the United States between 2014 and 2016.DesignWe conducted simple and multivariable logistic regression analyses to identify associations between user characteristics and contraceptive use, with specific attention to methods requiring a visit to a health care provider.SettingNot applicable.PatientsAll self-identified female respondents to the surveys. Secondary analysis of two rounds of the National Survey of Family Growth, an in-home, nationally representative survey of people ages 15-44 years (2013-2015) and 15-49 years (2015-2017).InterventionsNone.Main outcome measuresCurrent use of a contraceptive method, including use of individual methods and grouped method use in 2016, and change in use from 2014.ResultsContraceptive use remained steady between 2014 and 2016 among sexually active females not seeking pregnancy (88%). Among users, use of long-acting reversible contraceptive (LARC) methods increased from 14% to 18%, as use of short-acting reversible contraceptive (SARC) methods fell from 32% to 28%. Implant use among 15- to 19-year-olds rose from 6% to 16% and represents one of the largest increases observed. Access to sexual and reproductive health care was strongly associated with use of all LARC and SARC methods except for the implant (adjusted odds ratios ranged from 3.21 to 13.53).ConclusionsContraceptive users are shifting primarily among the most and moderately effective method groups, and not from contraceptive nonuse to use. Reductions in access to sexual and reproductive health care could have implications for individuals' ability to use their preferred contraceptive methods.
| S-EPMC8244260 | biostudies-literature
Project description:Importance:Melanoma is epidemiologically linked to UV exposure, particularly childhood sunburn. Public health campaigns are increasing sun-protective behavior in the United States, but the effect on melanoma incidence is unknown. Objective:To examine the incidence of melanoma in the United States and whether any age-specific differences are present. Design, Setting, and Participants:Observational, population-based registry data were extracted on July 3, 2018, from the combined National Program of Cancer Registries-Surveillance Epidemiology and End Results United States Cancer Statistics database for 2001-2015. Deidentified data for 988?103 cases of invasive melanoma, with International Classification of Diseases for Oncology histologic categorization codes 8720 to 8790, were used for analysis. Data analysis was performed from July 1, 2018, to March 1, 2019. Main Outcomes and Measures:The annual rates of melanoma in pediatric, adolescent, young adult, and adult age groups were determined. Analyses were stratified by sex, and incidence rates were age-adjusted to the 2000 US standard population. Annual percentage change (APC) in incidence rate was calculated over the most recent decade for which data were available (2006-2015) using the weighted least squares method. Results:In 2015, 83?362 cases of invasive melanoma were reported in the United States, including 67 in children younger than 10 years, 251 in adolescents (10-19 years), and 1973 in young adults (20-29 years). Between 2006 and 2015, the overall incidence rate increased from 200.1 to 229.1 cases per million person-years. In adults aged 40 years or older, melanoma rates increased by an APC of 1.8% in both men (95% CI, 1.4%-2.1%) and women (95% CI, 1.4%-2.2%). In contrast, clinically and statistically significant decreases were seen in melanoma incidence for adolescents and young adults. Specifically, incidence rates decreased by an APC of -4.4% for male adolescents (95% CI, -1.7% to -7.0%), -5.4% for female adolescents (95% CI, -3.3% to -7.4%), -3.7% for male young adults (95% CI, -2.5% to -4.8%), and -3.6% for female young adults (95% CI, -2.8% to -4.5%). Data on skin pigmentation and sun protection history were unavailable; similar trends were observed with data limited to non-Hispanic whites. Young adult women appeared to have twice the risk of melanoma as young adult men. Conclusions and Relevance:The incidence of invasive melanoma in the United States appeared to decrease in adolescents and young adults from 2006 to 2015, and this finding contrasted with increases in older populations. These incidence trends suggest that public health efforts may be favorably influencing melanoma incidence in the United States.
| S-EPMC6865303 | biostudies-literature
Project description:BackgroundA hormonal aetiology is one explanation for the lower incidence of myeloid leukaemia in women compared with men.MethodsIn this population-based case-control study, we evaluated associations between exogenous hormone use and reproductive history and myeloid leukaemia, overall and by disease subtype.ResultsWe observed a suggestive association between oral contraceptive use and acute myeloid leukaemia (odds ratio=0.55, 95% confidence interval=0.32-0.96). Hormone replacement therapy and reproductive factors were not associated with risk.ConclusionDespite the biological plausibility for a role of oestrogen in leukaemogenesis, other aetiologic factors are likely to explain the differing incidence rates in males and females.
| S-EPMC3790163 | biostudies-literature
Project description:Opioid use during pregnancy has been linked to several adverse outcomes including stillbirth, preterm birth and neonatal abstinence syndrome. Recent data suggest that heroin use has increased in the United States (US) whereas prescription opioid use has decreased. Prevalence estimates for reproductive age women combine heroin and non-medical prescription opioid use, which might mask the increasing heroin trend. The aim of the current study is to estimate the prevalence of heroin use among US women of reproductive age, stratified by pregnancy status. For each year, a representative sample of the US civilian non-institutionalized population is recruited for the National Survey on Drug Use and Health (NSDUH). Pregnancy status and heroin use were assessed in women 15-44 years of age (n = 277,333) using audio computerized-assisted self-interviews. From 2004 to 2017, the prevalence of past 30-day heroin use was 12 per 10,000 reproductive age women (95% confidence interval [CI] = 11, 14). Heroin use has increased from 6 per 10,000 women in 2004-05 to 18 per 10,000 women in 2016-17 (Average percent change = 20.8; 95% 11.2, 31.2). The increase was evident among non-pregnant women, but not among pregnant women. Heroin use remains uncommon among women of reproductive age, yet its prevalence has increased over time. Screening for heroin use might be needed at multiple time points including prior to pregnancy to mitigate adverse outcomes associated with use during pregnancy.
| S-EPMC7415610 | biostudies-literature
Project description:Background: Although endometrial cancer risk differs among white and black women, few data on its associations with exogenous hormone use in the latter group are available. Studies have reported lower endometrial cancer risk among users of oral contraceptives (OCs), but higher risk among users of estrogen-only female menopausal hormones (FMHs). Evidence for the risk among estrogen plus progestin FMHs users is equivocal.Methods: We followed 47,555 Black Women's Health Study participants with an intact uterus from 1995 through 2013. Data on exogenous hormone use, covariates, and endometrial cancer were obtained biennially. Self-reported incident cases of endometrial cancer were confirmed by medical records or cancer registries whenever possible. We estimated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression.Results: We observed 300 endometrial cancer cases during 689,546 person-years of follow-up. Compared with never use, ≥10 years' duration of OC use was associated with lower risk (multivariable IRR = 0.45, 95% CI, 0.27-0.74), but risk was higher among current users of estrogen-only (IRR = 3.78, 95% CI, 1.69-8.43) and estrogen plus progestin FMH (IRR = 1.55, 95% CI, 0.78-3.11). Risk was not increased among former users of estrogen-only (IRR = 0.87, 95% CI, 0.44-1.72) or estrogen plus progestin FMH (IRR = 0.63, 95% CI, 0.36-1.09).Conclusions: Current use of estrogen-only and estrogen plus progestin FMH was associated with increased risk of endometrial cancer. Risk appeared lower among former users of estrogen plus progestin FMH. Long-term OC use was associated with reduced risk.Impact: Our results are generally consistent with those among white women. Cancer Epidemiol Biomarkers Prev; 27(5); 558-65. ©2018 AACR.
| S-EPMC5991910 | biostudies-literature
Project description:BackgroundIntrahepatic cholangiocarcinoma (ICC) arises from cholangiocytes in the intrahepatic bile duct and is the second most common type of liver cancer. Cholangiocytes express both oestrogen receptor-α and -β, and oestrogens positively modulate cholangiocyte proliferation. Studies in women and men have reported higher circulating oestradiol is associated with increased ICC risk, further supporting a hormonal aetiology. However, no observational studies have examined the associations between exogenous hormone use and reproductive factors, as proxies of endogenous hormone levels, and risk of ICC.MethodsWe harmonised data from 1,107,498 women who enroled in 12 North American-based cohort studies (in the Liver Cancer Pooling Project, LCPP) and the UK Biobank between 1980-1998 and 2006-2010, respectively. Cox proportional hazards regression models were used to generate hazard ratios (HR) and 95% confidence internals (CI). Then, meta-analytic techniques were used to combine the estimates from the LCPP (n = 180 cases) and the UK Biobank (n = 57 cases).ResultsHysterectomy was associated with a doubling of ICC risk (HR = 1.98, 95% CI: 1.27-3.09), compared to women aged 50-54 at natural menopause. Long-term oral contraceptive use (9+ years) was associated with a 62% increased ICC risk (HR = 1.62, 95% CI: 1.03-2.55). There was no association between ICC risk and other exogenous hormone use or reproductive factors.ConclusionsThis study suggests that hysterectomy and long-term oral contraceptive use may be associated with an increased ICC risk.
| S-EPMC7374167 | biostudies-literature