Perineal use of talc and risk of ovarian cancer

Our plain-English summary of Perineal use of talc and risk of ovarian cancer, by H. Langseth, S.E. Hankinson, J. Siemiatycki, et al (Journal of Epidemiology and Community Health, 2008).

The study

• Authors: H. Langseth, S.E. Hankinson, J. Siemiatycki, E. Weiderpass
• Journal: Journal of Epidemiology and Community Health
• Published: 2008;62(4):358-60
• Type of article: Review
• Cited by: 27 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Ovarian cancer is one of the most common gynaecological neoplasms, especially in industrialised countries. The aetiology of the disease is not well understood, except that inherited mutations in the breast cancer genes BRCA-1 and BRCA-2 account for up to 10% of all cases, and child-bearing, oral contraceptive use and breast-feeding reduce the risk. Some environmental exposures, notably talc and asbestos, have been suspected as ovarian carcinogens.

In plain English

This article reviewed published research on whether applying talc to the genital (perineal) area was linked to ovarian cancer. The authors examined one cohort study and 20 case-control studies (14 population-based, six hospital-based). The cohort study found no association between cosmetic talc use and all ovarian cancer subtypes combined. In the case-control studies, odds ratios ranged from 1.0 to 3.9. Ten of these studies showed a statistically significant excess risk, and ten showed a non-significant excess or none. The authors' pooled odds ratios were 1.40 for population-based studies, 1.12 for hospital-based studies and 1.35 for all case-control studies. Studies that examined frequency or years of use found no clear trend. Before 1976, talc was to some extent contaminated with asbestos, but the association was as strong in recent studies as in earlier ones. The authors concluded that perineal talc use may be associated with ovarian cancer risk, but that the evidence was insufficient to establish a causal association. They also noted that recall bias could not be ruled out.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review of published epidemiological studies (one cohort study and 20 case-control studies), with pooled odds ratios calculated by fixed effects model
• Who was studied: Published studies of women: one cohort study and 20 case-control studies, 14 population-based (112 to 824 ovarian cancer cases each) and six hospital-based (77 to 462 cases each); most were among American women
• Exposure: Perineal use of cosmetic talc, including talc-based body powders, baby powders and feminine hygiene products; before 1976 talc was to some extent contaminated with asbestos
• Main results:
  • In the one cohort study, there was no association between cosmetic talc use and risk of all subtypes of ovarian cancer combined
  • Across the 20 case-control studies, odds ratios ranged from 1.0 to 3.9. Ten showed a significant excess risk and ten a non-significant excess risk or null; none reported relative risks below 1.0
  • Pooled odds ratios were 1.40 for population-based, 1.12 for hospital-based and 1.35 for all case-control studies combined (confidence intervals not given in the text)
  • In the eight population-based case-control studies the IARC working group judged most informative, each indicated a 30 to 60% increase in risk among body powder users
  • Studies that tried to assess exposure-response, by frequency or length of use, found no clear trend
  • In four of the five studies reporting by histological type, in particular the cohort study, there were hints of higher risks of serous tumours
  • The association was as strong in recent studies as in earlier ones, which the authors said diminished the likelihood that all results were influenced by asbestos contamination of talc
• The authors' conclusion: The authors concluded that, on balance, epidemiological evidence suggests perineal use of cosmetic talc may be associated with ovarian cancer risk, but that current evidence is insufficient to establish a causal association
• Limitations the authors state:
  • Recall bias, from women with cancer remembering or over-reporting body powder use, cannot be ruled out
  • Early studies may have been confounded by asbestos contamination of talc before 1976
  • The apparent lack of exposure-response trends may result from crude exposure measures
  • Most studies were among American women
  • The evidence is insufficient to establish a causal association

Topics

The National Library of Medicine indexes this study under subjects our site covers: Ovarian cancer, Talc and vermiculite.

Medical terms in this study, explained in our Lexicon: Talc, Ovarian Cancer, Neoplasm, Germline Mutation, Environmental Exposure.

Related studies

• Perineal talc use and ovarian cancer: a critical review — J.E. Muscat, M.S. Huncharek (2008)
• Perineal talc exposure and epithelial ovarian cancer risk in the Central Valley of California — P.K. Mills, D.G. Riordan, et al. (2004)
• Perineal talc use and ovarian cancer risk: a case study of scientific standards in environmental epidemiology — M. Huncharek, J. Muscat (2011)
• A review of perineal talc exposure and risk of ovarian cancer — B.L. Harlow, P.A. Hartge (1995)
• Cosmetic talc and ovarian cancer — D.L. Longo, R.C. Young (1979)
• Serous Ovarian Cancer Caused by Exposure to Asbestos and Fibrous Talc in Cosmetic Talc Powders-A Case Series — J.E. Steffen, T. Tran, et al. (2020)

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