Long-term exposure to commonly used estrogen-based contraceptives was not associated with malignant melanoma in a single-center retrospective study of more than 77,000 women.
This null result belied decades-old studies performed when contraceptives contained much higher doses of estrogen, Kelly A. Mueller of Northwestern University, Chicago, said in a poster presented at the annual meeting of the Society for Investigative Dermatology. Current microdosing of ethinyl estradiol (EE) “is not associated with subsequent diagnosis of melanoma in our population, and is not inconsistent with the full prescribing information for commonly prescribed contraceptives containing EE,” she said. The study also shows how large retrospective analyses of long-term follow-up data can inform pharmacovigilance for rare, serious medical events.
Prior work has found conflicting evidence for the role of estrogens in melanogenesis, said Ms. Mueller, who conducted the study under the supervision of, professor of dermatology at Northwestern. However, older studies repeatedly linked malignant melanoma with exogenous estrogen exposure, and rates of this cancer are higher in young women, compared with men, before dropping along with estrogen levels after menopause. Currently, the prescribing information for oral, skin patch, and vaginal ring estrogen-based contraceptives lists hormone-sensitive tumors as a possible concern, but does not specify melanoma.