Personal History of Endometriosis and Risk of Cutaneous Melanoma in a Large Prospective Cohort of French Women
An association between melanoma and endometriosis
has been reported, but most findings relied
on case-control studies or a limited number of melanoma
cases, and therefore the available evidence is weak.
Moreover, the effect of other benign gynecological diseases
on melanoma risk is unknown.
We prospectively studied data from the Etude
Epide´miologique auprès de femmes de la Mutuelle Ge´ne
´rale de l’EducationNationale cohort, which includes 98 995
French women, insured by a national health scheme mostly
covering teachers, aged 40 to 65 years at inclusion. Data
on history of endometriosis and other benign gynecological
diseases were regularly collected, starting in 1990. Relative
risks and95%confidence intervals were computed using
Cox proportional hazards regression models.
During 12 years of follow-up, 363 melanoma cases were ascertained among 91 965 subjects. A history of endometriosis (n=5949) was significantly associated with a higher risk of melanoma (relative risk, 1.62; 95% confidence interval, 1.15-2.29). There was also a significantly increased risk among women with a history of fibroma (n=24 375), compared with those who had no such history (relative risk, 1.33; 95% confidence interval, 1.06-1.67). A history of ovarian cyst, uterine polyp, breast adenoma/fibroadenoma, or breast fibrocystic disease was not significantly associated with risk.
These data provide the strongest evidence to date of a positive association between a history of endometriosis and melanoma risk. The association between
fibroma and melanoma, which has not been previously described, warrants further investigation.