A literature review on the link between oral contraceptives and melanoma with a proposal for research on progestin-only oral contraception and melanoma incidence

Problem: The link between oral contraceptives (OCs) and melanoma has been studied in great detail over the past thirty years. The available evidence suggests that the skin responds to estrogen, progestin and androgen. To date, much of the research has been centered on combination OCs with all emphasis and interest of study focused on the estrogen component. This literature review includes many of the prominent studies on the effects of hormones and the skin as well as the association between OC use and melanoma. Methods: The studies included were obtained through Weill Cornell Medical College (WCMC) library website with dates ranging from 1970--2008. Original case report studies, a pooled-analysis, meta-analyses, a prospective cohort study and peer-reviews were included in this review. All full-text articles obtained via WCMC library website concerning the present topic were included. No articles were excluded. Results: When the research began, higher dose OCs were the focus of study; however, more of the recent research has been centered on the modern low dose combinations. The results from many studies have been widely variable. Significant associations between OC use and melanoma development have been found while some studies have shown no significant association. The wide variations in results may be due to the differing study designs, inclusion criteria, and the ever-changing OC preparations. What has remained constant has been the focus of study on the estrogen component of OCs. Conclusion: No research has been placed on the progestin component thus far and with similar scientific characteristics as estrogen, new research with focus on progestin could prove to be promising in the overall understanding of the link between OCs and melanoma.