By Anne Harding
NEW YORK (Reuters Health) - Women who use menopausal hormone therapy (MHT), as well as those who go through menopause late, are at increased risk of basal cell carcinoma (BCC), new findings show.
"Although basal cell carcinoma is rarely fatal, it does contribute to substantial morbidity and health care costs if it's not detected early," Dr. Elizabeth Cahoon of the National Cancer Institute in Bethesda, Maryland, the study's first author, told Reuters Health in a telephone interview. "Women who use photosensitizing medications, like MHT, could be in need of more frequent cancer screening."
Investigators first recognized that oral contraceptives (OCs) could increase sun sensitivity in the 1960s, Dr. Cahoon and her team noted in their report, published online November 2 in the Journal of Clinical Oncology. Because exogenous estrogens make skin more sensitive to the effects of ultraviolet radiation (UVR), they added, they may increase photocarcinogenesis.
To investigate the effect of reproductive factors and exogenous estrogen use on BCC risk, Dr. Cahoon and her team looked at data from the US Radiologic Technologists Study on 46,100 white females who had no history of cancer at baseline. During follow-up, which lasted up to 10 years, 1,730 women developed BCC.
Women who underwent natural menopause at 55 or older had a 50% higher risk of BCC than women whose menopause occurred naturally when they were 50 to 54 years old, the researchers found. None of the other reproductive factors studied, such as age at menarche or parity, was associated with BCC.
Women who had ever used MHT were also at higher risk (hazard ratio 1.16). The risk was seen in women who took estrogen only as well as those who took estrogen/progestin. However, the risk associated with MHT was lower for women who had undergone a hysterectomy.
The longer a woman had used MHT, the more her risk of BCC increased (p for trend 0.01). Women who used MHT for 10 years or longer were at nearly double the risk of BCC compared to women who had never used MHT.
"One thing we did find was that the risk started to increase very early in terms of duration of use," said Dr. Cahoon. After a year on MHT, she explained, BCC risk was already significantly higher.
"The frequency of skin checks (for skin cancer) varies between women, the recommendation would vary based on your personal risk factors," she added. "This could be another potential risk factor to add to the list to think about how often that screening is done."
The authors reported no funding or disclosures.
SOURCE: https://bit.ly/1HtxQ3V
J Clin Oncol 2015.
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