Menopausal Hormone Therapy May Raise Risk Of Basal Cell Carcinoma Interview with:
Elizabeth K. Cahoon, PhD
Radiation Epidemiology Branch
Division of Cancer Epidemiology and Genetics, National Cancer Institute
National Institutes of Health
Department of Health and Human Services
Bethesda, MD

Medical Research: What is the background for this study? What are the main findings?

Dr. Cahoon: Although basal cell carcinoma (BCC) is the most common cancer in the United States, there is relatively little research on risk factors since few population-based cancer registries do not capture information on this malignancy.

Sun exposure (in particular ultraviolet radiation) is the primary risk factor for basal cell carcinoma, but less is known about other factors that may affect this risk. A previous study found a relationship between menopausal hormone therapy (MHT) use and increased risk of BCC in a population of Danish women.

In our study we looked to see if factors related to estrogen exposure from multiple sources was associated with basal cell carcinoma risk in a large, nationwide, prospective study. These included use of oral contraceptives or menopausal hormone therapy, but also reproductive factors (like age at menarche and menopause).

We observed that women who experienced natural menopause later in life were more likely to develop basal cell carcinoma compared to women who had natural menopause at a younger age.

In addition, women who reported using menopausal hormone therapy for one year or longer were more likely to develop basal cell carcinoma compared to women who did not report MHT use.

Women who reported natural menopause and menopausal hormone therapy use for 10 or more years had the highest risk of basal cell carcinoma, compared to women with no menopausal hormone therapy use.

Medical Research: What should clinicians and patients take away from your report?

Dr. Cahoon: Although rarely fatal, basal cell carcinoma contributes to substantial morbidity and health care costs. Women who use photosensitizing medications such as menopausal hormone therapy may constitute an additional high-risk group in need of more frequent skin cancer screening.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Cahoon: Future studies could collect more detailed information on medication use, ask participants about photosensitivity reactions, and collect biomarkers of female sex hormones in relation to risk of basal cell carcinoma. 


Cancer Prevention and Control:Female Estrogen-Related Factors and Incidence of Basal Cell Carcinoma in a Nationwide US Cohort

Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen,Michele M. Doody, Bruce H. Alexander, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman

JCO JCO.2015.62.0625; published online on November 2, 2015;

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Elizabeth K. Cahoon, PhD (2015). Menopausal Hormone Therapy May Raise Risk Of Basal Cell Carcinoma 

Last Updated on November 7, 2015 by Marie Benz MD FAAD