Presenting Author:

Kelly Mueller, B.S.

Principal Investigator:

Dennis West, Ph.D.

Department:

Dermatology

Keywords:

melanoma, estrogen, ethinyl estradiol, oral contraceptives

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C23 - Clinical Women's Health Research

Melanoma and low dose ethinyl estradiol contraceptives: a retrospective study

Introduction Although estrogen has been reported to be a modulator and growth stimulator of melanocytes, the role of estrogens in malignant melanoma remains unclear. Reported studies have yielded conflicting results regarding an association between melanoma and exogenous estrogen in contraceptives. Given that chronic exposure to low doses of exogenous estrogen in contraceptives is routine, the aim of this study was to determine if the most widely used compound in contraceptives, ethinyl estradiol (EE), at commonly prescribed low doses (between 10mcg/day-40mcg/day) correlated with melanoma in a large Midwestern U. S patient population. Methods We queried an electronic medical record data repository (Northwestern Medicine Enterprise Data Warehouse, > 3 million patients) using ICD-9 and ICD-10 base codes for melanoma (172, C43) and for those who had exposure to EE (vaginal ring, oral, or patch). Criteria for inclusion were young women (aged 18-40 years) who had a first clinic encounter anytime during a 10 year period (January 2001 to December 2011) followed by at least 5 years of clinic follow up. The incidence of melanoma was compared between women who had at least 12 months continuous exposure to low dose EE (N=4499) and women who had no EE exposure (N=112,601). Those who were diagnosed with melanoma less than 12 months after initial EE exposure were excluded. Results The difference in the incidence of melanoma between the two groups was not statistically significant (0. 4% for exposed and 0. 5% for non-exposed, p=0. 26). Notably, the findings in this study population are consistent with the reported national incidence of melanoma without regard to EE exposure (0. 5% in women aged 0-49). Conclusions These findings suggest that chronic exposure to low dose EE in contraceptives does not correlate with melanoma.