Premenopausal Use of Progestogens and Cutaneous Melanoma Risk: A French Prospective Cohort Study

Abstract We investigated the influence of premenopausal use of progestogens on melanoma using data from E3N (Etude Epidémiologique Auprès de Femmes de l’Education Nationale), a prospective cohort of 98,995 French women, aged 40–65 years at inclusion. We used Cox models to adjust for age and melanoma risk factors. Over 1992–2008, 540 melanoma cases were ascertained among 79,558 women. We found a modest association between self-reported progestogen use and melanoma risk (hazard ratio (HR) = 1.23, 95% confidence interval (CI) = 1.02, 1.47), which was reduced after adjustment for melanoma risk factors (HR = 1.15, 95% CI: 0.95, 1.39). There was no heterogeneity across types of progestogens (P = 0.22), and use of multiple progestogens was positively associated with melanoma risk (HR = 1.33, 95% CI: 1.04, 1.70). Among users, we found no relationship with duration of progestogen use, age at start and last use, and time since first and last use. Although our results did not show evidence of a confounding effect of sun exposure, progestogen users had lower levels of residential sun exposure and were more likely to report sunscreen use, suggesting specific sun exposure profiles in users. Our findings do not support a strong influence of progestogens on melanoma risk. Further research is needed to confirm these results.

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Patterns of familial aggregation of three melanoma risk factors: great number of naevi, light phototype and high degree of sun exposure

International Journal of Epidemiology ◽

10.1093/ije/29.3.408 ◽

2000 ◽

Vol 29 (3) ◽

pp. 408-415 ◽

Cited By ~ 11

Author(s):

L. Briollais

Keyword(s):

Risk Factors ◽

Familial Aggregation ◽

Sun Exposure ◽

Melanoma Risk ◽

High Degree

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Personal melanoma risk awareness versus intrinsic risk.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.9069 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 9069-9069

Author(s):

Caroline Robert ◽

Céleste Lebbé ◽

Sevrine Ricard ◽

Philippe Saiag ◽

Florent Grange ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Family History ◽

Sun Exposure ◽

Risk Level ◽

Control Group ◽

Melanoma Risk ◽

Protection Measures ◽

Frequent Use ◽

History Of

9069 Background: Intrinsic risk factors for melanoma include personal and family history of the condition, a high number of naevi and a light skin phototype (I or II). The objective of this study was to evaluate the correlation between personal awareness of melanoma risk and objective risk factors and to analyze the elements associated with under-or over-evaluation of the actual risk. Methods: EDIFICE melanoma, a nationwide French observational survey, was conducted through phone interviews on a representative sample of 1502 subjects aged ≥ 18 using typical quotas. The survey took place from 28th Sept 2011 to 20th Oct 2011. Results: 393 subjects (26%) had at least one melanoma risk factor: personal: 1%; family history: 11%; high number of naevi: 8% and phototype I-II: 11%. 1109 (74%) had no risk factor. 1029 (73%) had a correct perception of their risk level, 135 (10%) overestimated their risk and 241 (17%) underestimated it. Compared to the control group (correct perception), the population overestimating the melanoma risk is characterised by a higher percentage of individuals living alone (32% vs. 24%, p<0.05), socio-professional category + (38% vs. 28%, p<0.01) and greater alcohol consumption (45% vs. 34%, p<0.02). They are also more likely to expose themselves to the sun (89% vs. 78%, p<0.004) and less likely to use sunscreen protection (58% vs. 44%, p<0.003). A greater proportion of them participates in melanoma screening programmes (21% vs. 14%, p<0.04). The population that underestimates the risk is characterised by lower educational attainment (11% vs. 7%, p<0.05), greater use of high SPF sunscreen (41% vs. 29%, p<0.0004) and a more frequent use of UV sunbeds (9% vs. 6%, p<0.06). Conclusions: Overall, the French have a fair perception of their personal likelihood of developing melanoma. Interestingly, subjects overestimating their intrinsic risk do not behave appropriately with respect to sun protection measures (more sun exposure and less sunscreen protection). On the other hand, subjects underestimating their risk use UV sunbeds more extensively.

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Current Data on Risk Factor Estimates Does Not Explain the Difference in Rates of Melanoma between Hispanics and Non-Hispanic Whites

Journal of Skin Cancer ◽

10.1155/2016/2105250 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Sonia Kamath ◽

Kimberly A. Miller ◽

Myles G. Cockburn

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Current Knowledge ◽

Sun Exposure ◽

Incidence Rates ◽

Melanoma Risk ◽

Similar Frequency ◽

Red Hair ◽

Melanoma Incidence ◽

The Difference

United States Hispanics have seven times lower melanoma incidence rates than non-Hispanic whites (NHW). It is unclear whether this difference can be explained solely by phenotypic risk factors, like darker skin, or whether modifiable risk factors, like sun exposure, also play a role. The purpose of this paper is to summarize what is currently known about melanoma risk factors among Hispanics and NHWs, and whether or not those differences could explain the difference in melanoma incidence. Through literature review, relative risks and prevalence of melanoma risk factors in Hispanics and NHWs were identified and used to calculate the expected rate in Hispanics and rate ratio compared to NHWs. We found that melanoma risk factors either have similar frequency in Hispanics and NHWs (e.g., many large nevi) or are less frequent in Hispanics but do not explain a high proportion of disease variation (e.g., red hair). Considering current knowledge of risk factor prevalence, we found that melanoma incidence rates in the two groups should actually be similar. Sun exposure behavior among Hispanics may contribute to the explanation for the 7-fold difference in melanoma rates. Currently, limited data exist on sun exposure behavior among Hispanics, but possibilities for improving primary prevention by further studying these practices are substantial.

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Patterns of familial aggregation of three melanoma risk factors: great number of naevi, light phototype and high degree of sun exposure

International Journal of Epidemiology ◽

10.1093/intjepid/29.3.408 ◽

2000 ◽

Vol 29 (3) ◽

pp. 408-415 ◽

Cited By ~ 9

Author(s):

Laurent Briollais ◽

Agnès Chompret ◽

Michel Guilloud-Bataille ◽

Brigitte Bressac-de Paillerets ◽

Marie-Françoise Avril ◽

...

Keyword(s):

Risk Factors ◽

Familial Aggregation ◽

Sun Exposure ◽

Melanoma Risk ◽

High Degree

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Incorporating Polygenic Risk Scores and Nongenetic Risk Factors for Breast Cancer Risk Prediction among Asian Women, Results from Asia Breast Cancer Consortium

10.1101/2021.09.23.21263888 ◽

2021 ◽

Author(s):

Yaohua Yang ◽

Ran Tao ◽

Xiang Shu ◽

Qiuyin Cai ◽

Wanqing Wen ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Risk Prediction ◽

Prospective Cohort ◽

Risk Scores ◽

Asian Women ◽

Genome Wide ◽

Using Data

Importance Polygenic risk scores (PRSs) have shown promises in breast cancer risk prediction; however, limited studies have been conducted among Asian women. Objective To develop breast cancer risk prediction models for Asian women incorporating PRSs and nongenetic risk factors. Design PRSs were developed using data from genome-wide association studies (GWAS) of breast cancer conducted among 123 041 Asian-ancestry women (including 18 650 cases) using three approaches (1) reported PRS for European-ancestry women; (2) breast cancer-associated single-nucleotide polymorphisms (SNPs) identified by fine-mapping of GWAS-identified risk loci; (3) genome-wide risk prediction algorithms. A nongenetic risk score (NgRS) was built including six well-established nongenetic risk factors using data from 1974 Asian women. Integrated risk scores (IRSs) were constructed using PRSs and the NgRS. PRSs were initially validated in an independent dataset including 1426 cases and 1323 controls and further evaluated, along with the NgRS and IRSs, in the second dataset including 368 cases and 736 controls nested withing a prospective cohort study. Setting Case-control and prospective cohort studies. Participants 20 444 breast cancer cases and 106 450 controls from the Asia Breast Cancer Consortium. Main Outcomes and Measures Logistic regression was used to examine associations of risk scores with breast cancer risk to estimate odds ratios (ORs) with 95% confidence intervals (CIs) and area under the receiver operating characteristic curve (AUC). Results In the prospective cohort, PRS111, a PRS with 111 SNPs, developed using the fine-mapping approach showed a prediction performance comparable to a genome-wide PRS including over 855,000 SNPs. The OR per standard deviation increase of PRS111 was 1.67 (95% CI=1.46-1.92) with an AUC of 0.639 (95% CI=0.604-0.674). The NgRS had a limited predictive ability (AUC=0.565; 95% CI=0.529-0.601); while IRS111, the combination of PRS111 and NgRS, achieved the highest prediction accuracy (AUC=0.650; 95% CI=0.616-0.685). Compared with the average risk group (40th-60th percentile), women in the top 5% of PRS111 and IRS111 were at a 3.84-folded (95% CI=2.30-6.46) and 4.25- folded (95% CI=2.57-7.11) elevated risk of breast cancer, respectively. Conclusions and Relevance PRSs derived using breast cancer-associated risk SNPs have similar prediction performance in Asian and European descendants. Including nongenetic risk factors in models further improved prediction accuracy. Our findings support the utility of these models in developing personalized screening and prevention strategies.

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Melanoma: risk factors and advice on sunscreen use

The Pharmaceutical Journal ◽

10.1211/pj.2017.20202889 ◽

2017 ◽

Keyword(s):

Risk Factors ◽

Melanoma Risk ◽

Sunscreen Use

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A Randomized Trial of Precision Prevention Materials to Improve Primary and Secondary Melanoma Prevention Activities among Individuals with Limited Melanoma Risk Phenotypes

Cancers ◽

10.3390/cancers13133143 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3143

Author(s):

John Charles A. Lacson ◽

Scarlet H. Doyle ◽

Lu Qian ◽

Jocelyn Del Rio ◽

Stephanie M. Forgas ◽

...

Keyword(s):

Risk Factors ◽

Disease Risk ◽

Sun Exposure ◽

Sun Protection ◽

Average Risk ◽

Melanoma Risk ◽

Intervention Effects ◽

Central Florida ◽

Primary Care Clinics ◽

To Receive

Inherited variation at MC1R is associated with elevated melanoma risk among non-Hispanic whites (NHWs). MC1R genetic testing may unmask previously unrecognized disease risk, especially among individuals with few melanoma phenotypic risk factors. We recruited NHW individuals with limited phenotypic risk factors from two primary care clinics in west-central Florida. Participants (n = 1134) were randomized within MC1R genotype risk group (average/higher) to receive mailed precision prevention (i.e., intervention) or generic prevention materials. Participants reported hours of weekday and weekend sun exposure, frequency of intentional outdoor tanning and sun protection behaviors, number of sunburns, indoor tanning episodes, and skin examinations at baseline, and after 6 and 12 months. Among MC1R higher-risk participants, the intervention increased the likelihood of often or always wearing a shirt with sleeves (OR = 1.49, p = 0.03) and seeking shade or using an umbrella (OR = 1.42, p = 0.046), and it decreased the number of sunburns among their young children (β = −0.13, p = 0.03). Intervention effects were not noted among MC1R average-risk participants. Moderation analyses identified intervention effects within subgroups in average-risk and higher-risk participants. Precision prevention information conveying MC1R testing results can increase the practice of some sun protection behaviors among at-risk individuals with limited melanoma risk phenotypes and may provide a cross-generational tool to counteract increasing incidence of melanoma.

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