Skin cancer risk of Hormonal Contraception

Skin expresses estrogen, progesterone, and androgen receptors. Steroid hormones, such as those contained in oral contraceptives,affect skin cell cycle control.

Consequently, they can induce increase of epidermal growth factor signaling, expression of proto-oncogenes, inhibition of apoptosis, DNA replication and, potentially can promote tumor development.

However, available evidence suggests that while the skin responds to estrogens, progestins, and androgens, these responses do not significantly increase the risk of developing skin cancer when estrogen exposure is not excessive ^(76,77). The question of whether oral contraceptives increase the risk for the development of skin cancer, particularly melanoma is still an area of concern ^(76,77).

Several studies confirmed that ever being pregnant, age at first pregnancy, current use of hormonal contraceptives, duration of their use,and age at first use of oral contraceptives have an absence or no consistent association with melanoma ^(78,79,80).

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While, women who had had three or more children seem to be significantly protected as compared to nulliparous ones. In fact seems that women with both earlier age at first birth (< 20 years) and higher parity (> or=5live birth)have a particular lower risk than women with later age at first birth (> or=25 years) and lower parity. ^(81,82,83).

However, other factors could act ,such as excessive sun exposure as beach holidays for 3 weeks or more. ⁽⁸²⁾.

In fact, history of sunburn and intensive sun-UV exposure, both can are important factors for the development of melanocytic nevi and,indirectly for melanoma ^(76,83,84).

Intermittent and intense sun exposure, during the life, could increase the risk,while prolonged exposure,as during outdoor works,seems not associated with the same risk ^(85,86).

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Evidence suggests that there is no causal link between oral contraceptive use and melanoma or with benign melanocytic nevi, nor has a specific subgroup of women been consistently implicated, as being at increased risk of this disease due to use of oral contraceptives ^(76,83,84).

However, based upon small numbers of cases, there was evidence that changes in nevi during recent pregnancies were a risk factor for melanoma (OR = 2.9) ^(76,83).

Reproductive hormonal factors may have a potential role in cutaneous melanoma but oral contraceptive use does not increase the risk of developing melanoma and generally skin cancer when estrogen exposure is not excessive ^{(86,87,88,89)}.

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