Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
J Invest Dermatol. 2021 Sep;141(9):2189-2196.e1. doi: 10.1016/j.jid.2021.02.752. Epub 2021 Mar 17.
Fertility drugs have not definitively been linked to malignant melanoma. By the use of data from a large nationwide cohort of women aged 20.0-45.0 years and living in Denmark between January 1, 1995 and December 31, 2011, we assessed the association between the use of fertility drugs and the risk of malignant melanoma. Information on fertility status and the use of fertility drugs was obtained from the population-based Danish Infertility Cohort. Cox proportional hazard regression models were applied to estimate hazard ratios and 95% confidence intervals with adjustment for potential confounders. The study population comprised 1,330,954 women, of whom 86,231 (6.5%) were treated with fertility drugs. During a median follow-up of 21.0 years, 6,139 women were diagnosed with malignant melanoma. Compared with fertile women, women with fertility challenges who had used any fertility drugs had an increased risk of malignant melanoma (hazard ratio = 1.14; 95% confidence interval = 1.02-1.27). Furthermore, the use of specific types of fertility drugs (clomiphene, gonadotropins, human chorionic gonadotropin, gonadotropin-releasing hormone preparations, and progesterone) was also associated with an increased risk of malignant melanoma, with hazard ratios ranging between 1.09 and 1.13; however, the association did not reach statistical significance. Our findings indicate that the use of fertility drugs was associated with a modestly increased risk of malignant melanoma.
生育药物与恶性黑色素瘤之间并未明确相关。通过使用丹麦全国范围内年龄在 20.0-45.0 岁之间的女性队列数据，这些女性在 1995 年 1 月 1 日至 2011 年 12 月 31 日期间居住在丹麦，我们评估了生育药物的使用与恶性黑色素瘤风险之间的关联。生育状况和生育药物使用的信息来自基于人群的丹麦不孕不育队列。应用 Cox 比例风险回归模型，估计了风险比和 95%置信区间，并对潜在混杂因素进行了调整。研究人群包括 1,330,954 名女性，其中 86,231 名（6.5%）接受了生育药物治疗。在中位随访 21.0 年期间，有 6,139 名女性被诊断为恶性黑色素瘤。与生育能力正常的女性相比，患有生育问题并使用任何生育药物的女性恶性黑色素瘤的风险增加（风险比=1.14；95%置信区间=1.02-1.27）。此外，使用特定类型的生育药物（氯米芬、促性腺激素、人绒毛膜促性腺激素、促性腺激素释放激素制剂和孕酮）也与恶性黑色素瘤风险增加相关，风险比在 1.09 到 1.13 之间；然而，这种关联没有达到统计学意义。我们的研究结果表明，生育药物的使用与恶性黑色素瘤的风险适度增加相关。
