Discontinuation of hormone replacement therapy or oral contraceptive pill
Non-systematic review evidence
A non-systematic literature search review was performed to answer the following question: Should hormone replacement therapy or oral contraceptive pill be discontinued upon development of melanoma?
Most of the data regarding the risk of melanoma associated with use of the oral contraceptive pill (OCP) or hormone replacement therapy (HRT) is based on epidemiological studies.
One cohort study found there was an increased risk of melanoma in women taking the OCP, and but no increase in the risk of melanoma in those who were not currently taking the OCP, but had done so in the past. However this study did not control for confounding factors such as sun exposure. In contrast, a case-control study found that there was no association between OCP use and melanoma, but an increased risk of melanoma in those who had used HRT and another large cohort study found no association between use of the OCP and melanoma.
A randomised controlled trial involving over 27,000 women that compared the incidence of melanoma in post-menopausal women in those taking HRT and those who did not take HRT, found that the use of HRT did not affect the incidence of melanoma and, furthermore, several meta-analyses and literature reviews found that use of the OCP or HRT was not associated with an increased risk of melanoma.
The use of HRT and the OCP does not influence the prognosis of melanoma.
Evidence regarding the use of the OCP and HRT and the risk of melanoma is insufficient to demonstrate an association.
There is no convincing evidence that either hormone replacement therapy (HRT) or the use of the oral contraceptive pill (OCP) affects the natural history of melanoma.
Evidence summary and practice points
|The use of HRT or the OCP does not affect the natural history of melanoma.||III-3||, , , , , , , , , , , , , , , , , , |
|The use of HRT or the OCP does not increase the risk of melanoma||III-3||, , , , , , |
|The use of HRT or the OCP does not influence the prognosis of melanoma||III-3|||
HRT and the OCP are not contraindicated in women who currently have or have had melanoma.
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