title: Role of BMI and hormone therapy in melanoma risk: a case-control study.
abstract: BACKGROUND
  Currently, the association between body mass index (BMI) and hormone therapies and Cutaneous Melanoma (CM) development is strongly debated. This study was carried out to assess the association between BMI, hormone therapies, and CM risk.
  
  
  METHODS
  The present study is a hospital-based case-control study with 605 consecutive CM patients and 592 controls treated for non-neoplastic conditions at the Department of Dermatology in Florence. The associations of melanoma risk with BMI and hormone therapies were assessed performing unconditional logistic regression to estimate odds ratios (OR) and their 95% confidence intervals, adjusting for potential confounders.
  
  
  RESULTS
  We found a significant interaction of BMI with age (P < 0.0001): being overweight significantly increased CM risk among individuals less than 50 years old (OR = 1.85 with 95% CI 1.14-2.94), whereas the association was not significant for individuals over 50 years old (OR = 1.15 with 95% CI 0.77-1.71). For oestrogen therapy, women taking oral contraceptives (OCs)/hormone replacement therapy (HRT) showed a lower CM risk than men (OR = 0.63, 95% CI 0.44-0.89), with risk estimates significantly lower (P < 0.0001) than in non OCs/HRT users, which had an increased risk compared to men (OR = 1.81, 95% CI 1.29-2.53).
  
  
  CONCLUSIONS
  Being overweight was significantly associated with CM risk, and this relationship was highly age-conditioned; the second finding was the protective effect of oestrogen therapies for women. Both findings may have a significant impact on melanoma prevention, as the prevalence of obesity and hormone therapy use is increasing worldwide.
authors.affiliation: Department of Dermatology, University of Florence, Via Michelangelo 41, 50124, Florence, Italy. vincenzo.degiorgi@unifi.it.|Cancer Research "Attilia Pofferi" Foundation, Pistoia, Italy. vincenzo.degiorgi@unifi.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Giorgi
authors.affiliation: Cancer Research "Attilia Pofferi" Foundation, Pistoia, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Gori
authors.affiliation: Department of Dermatology, University of Florence, Via Michelangelo 41, 50124, Florence, Italy.
authors.forename: Imma
authors.initials: I
authors.lastname: Savarese
authors.affiliation: Department of Dermatology, University of Florence, Via Michelangelo 41, 50124, Florence, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: D'Errico
authors.affiliation: Department of Dermatology, University of Florence, Via Michelangelo 41, 50124, Florence, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Scarfì
authors.affiliation: Department of Dermatology, University of Florence, Via Michelangelo 41, 50124, Florence, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Papi
authors.affiliation: Department of Human Pathology and Oncology, University of Florence, Florence, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Maio
authors.affiliation: Department of Dermatology, University of Perugia, Perugia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Covarelli
authors.affiliation: Department of Human Pathology and Oncology, University of Florence, Florence, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Massi
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008545:Melanoma / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D050177:Overweight / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012878:Skin Neoplasms / Q000150:complications / Q000453:epidemiology*; D000096142:Cutaneous Malignant Melanoma
keywords: Age; Body mass index; Cutaneous melanoma; Hormone therapies; Overweight status