Farland Leslie V, Lorrain Simon, Missmer Stacey A, Dartois Laureen, Cervenka Iris, Savoye Isabelle, Mesrine Sylvie, Boutron-Ruault Marie-Christine, Kvaskoff Marina
Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA.
Department of Obstetrics, Gynaecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA.
Cancer Causes Control. 2017 Oct;28(10):1011-1019. doi: 10.1007/s10552-017-0939-2. Epub 2017 Aug 10.
Endometriosis has been associated with an increased risk of skin melanoma. However, associations with other skin cancer types and how they compare with melanoma are unclear. Our objective was to prospectively investigate the relationships between endometriosis and risk of non-melanoma and melanoma skin cancers.
E3N is a prospective cohort of 98,995 French women aged 40-65 years in 1990. Data on surgically confirmed endometriosis and skin cancer diagnoses were collected every 2-3 years through self-report, with skin cancer cases confirmed through pathology reports. Hazard Ratios (HR) and 95% confidence intervals (CIs) were calculated using Cox regression models.
Between 1990 and 2008, 535 melanoma, 247 squamous-cell carcinoma (SCC), and 1,712 basal-cell carcinoma (BCC) cases were ascertained. Endometriosis was associated with an increased overall risk of skin cancer (HR 1.28, 95% CI 1.05-1.55). When considering skin cancer type, endometriosis was associated with melanoma risk (HR 1.64, 95% CI 1.15-2.35), but not with SCC (HR 1.21, 95% CI 0.62-2.36) or BCC (HR 1.16, 95% CI 0.91-1.48) (non-melanoma skin cancers combined: HR 1.17, 95% CI 0.93-1.46), although no heterogeneity was detected across skin cancer types (Phomogeneity = 0.13).
These data support an association between a personal history of endometriosis and the risk of skin cancer and suggest that the association is strongest for melanoma.
子宫内膜异位症与皮肤黑色素瘤风险增加有关。然而，其与其他皮肤癌类型的关联以及与黑色素瘤相比情况如何尚不清楚。我们的目标是前瞻性研究子宫内膜异位症与非黑色素瘤及黑色素瘤皮肤癌风险之间的关系。
E3N是一项针对1990年年龄在40 - 65岁的98,995名法国女性的前瞻性队列研究。通过自我报告每2 - 3年收集一次经手术确诊的子宫内膜异位症和皮肤癌诊断数据，皮肤癌病例通过病理报告确诊。使用Cox回归模型计算风险比（HR）和95%置信区间（CI）。
在1990年至2008年期间，确定了535例黑色素瘤、247例鳞状细胞癌（SCC）和1,712例基底细胞癌（BCC）病例。子宫内膜异位症与皮肤癌总体风险增加相关（HR 1.28，95% CI 1.05 - 1.55）。在考虑皮肤癌类型时，子宫内膜异位症与黑色素瘤风险相关（HR 1.64，95% CI 1.15 - 2.35），但与SCC（HR 1.21，95% CI 0.62 - 2.36）或BCC（HR 1.16，95% CI 0.91 - 1.48）无关（非黑色素瘤皮肤癌合并：HR 1.17，95% CI 0.93 - 1.46），尽管在不同皮肤癌类型中未检测到异质性（P同质性 = 0.13）。
这些数据支持子宫内膜异位症个人病史与皮肤癌风险之间的关联，并表明这种关联在黑色素瘤中最强。
