J. A. DiSano1, E. W. Schaefer1, K. Kjerulff1, C. S. HollenbeaK1, C. R. Pameijer1 1Penn State Hershey Medical Center,Hershey, PA, USA
Introduction: Melanoma is the third most common cancer in women 18-39 years old. Few studies have examined pregnancy after melanoma. Our aims were to investigate the pregnancy rate after melanoma diagnosis and the relationship between melanoma treatment and subsequent pregnancy.
Methods: We studied women with a melanoma diagnosis in the Truven Health MarketScan database. Women were matched 1:1 to women with no melanoma diagnosis to compare pregnancy rates between groups. For women with melanoma, Cox models were fitted for rates of pregnancy overall, pregnancy if post-surgical treatment was received, and for treatment after pregnancy. The primary outcome was rates of pregnancy within two years of melanoma diagnosis. The secondary outcomes were rates of pregnancy in the setting of more advanced melanoma, and the impact of pregnancy on rates of additional treatment for melanoma.
Results: The sample included 12,674 women aged 18-40 years with melanoma. These women had a higher rate of pregnancy within 2 years compared to matched controls (19.6% vs 18.0%, p<0.001). For 0-9 months after diagnosis, women who received post-surgical treatment for their melanoma had a 74% lower hazard of becoming pregnant (HR=0.26, P=0.003). Rates of treatment received after pregnancy were not significantly different (HR=0.68, P=0.23).
Conclusion: Our study represents the largest population-based study of women with melanoma and the incidence of post-melanoma pregnancy in the United States to date. Women with melanoma were more likely to become pregnant than matched controls, but had a lower rate of pregnancy if they received post-surgical treatment. Recurrence rates were low in this time period, and no higher for women who became pregnant after their melanoma diagnosis.