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Systematic review of case-control studies: oral contraceptives show no effect on melanoma risk
A Pfahlberg1, K Hassan, L Wille
1Department of Medical Statistics, University of Göttingen, Germany. annette.pfahlberg@unix.ams.med.uni-goettingen.de
Background:
Parallel to the rising incidence of malignant melanoma in fair-skinned populations, intensive efforts are currently devoted to identifying risk factors for melanoma in addition to the well-known cutaneous factors and those variables related to UV-exposure.
Objective:
Systematic review of published results to elucidate the role of oral contraceptives in the development of malignant melanoma.
Data Sources:
Literature retrieval systems MEDLINE and CANCERLIT as well as reference lists of already collected studies.
Study Selection:
All 18 (non-duplicate) case-control studies on the above relationship.
Data Extraction:
From the published data, study-specific odds ratios (OR) and accompanying confidence intervals (CI) were recalculated. For a quantitative meta-analytical summarisation two different models have been applied: a "fixed effects" (FE) and a "random effects" (RE) model.
Data Synthesis:
Study-specific ORs ranged from 0.13 up to 1.85; however, the majority of studies (14 of 18) yielded similar ORs within the interval [0.82, 1.15]. The summary ORs estimated from FE- and RE-models were both 0.95 (95% CI: [0.87, 1.04] for the FE-model, [0.87, 1.05] for the RE-model).
Conclusion:
The systematic review of case-control studies revealed no evidence for an aetiological role of oral contraceptives in the development of malignant melanoma.