Perineal Talc Exposure and Subsequent Epithelial Ovarian Cancer: A Case-Control Study.
WONG, CHEUNG MD; HEMPLING, RONALD E. MD; PIVER, M. STEVEN MD; NATARAJAN, NACHIMUTHU MS; METTLIN, CURTIS J. PhD
Obstetrics & Gynecology.
93(3):372-376, March 1999.
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Objective: To evaluate the role of talcum powder use as a risk factor for the development of epithelial ovarian cancer.
Methods: In a case-control study, 499 patients with epithelial ovarian cancer were frequency matched for age at diagnosis ( /-5 years) with a control population of 755 patients. The odds ratio (OR) for the development of epithelial ovarian cancer was estimated using logistic regression analysis with adjustment for age at diagnosis, parity, oral contraceptive use, smoking history, family history of epithelial ovarian cancer, age at menarche, menopausal status, income, education, geographic location, history of tubal ligation, and previous hysterectomy.
Results: Two hundred twenty-one of 462 patients (47.8%) in the study population and 311 of 693 patients (44.9%) in the control population had ever used talcum powder (OR 0.92; 95% confidence interval [CI] 0.24, 3.62). A significant association between duration of talc use and development of epithelial ovarian cancer was not demonstrable for 1-9 years (OR 0.9; 95% CI 0.6, 1.5), for 10-19 years (OR 1.4; 95% CI 0.9, 2.2), or for more than 20 years (OR 0.9; 95% CI 0.6, 1.2). To eliminate the possible confounding variable of surgery for the management of ovarian cancer, we omitted 135 patients in the study population who underwent hysterectomy within 5 years of the diagnosis of ovarian cancer. Within this subgroup of patients, tubal ligation or hysterectomy among talc users still failed to demonstrate an increased risk for the development of ovarian cancer (OR 0.9; 95% CI 0.4, 2.2).
Conclusion: A significant association between the use of talcum powder and the risk of developing epithelial ovarian cancer is not demonstrable, even with prolonged exposure.
(C) 1999 The American College of Obstetricians and Gynecologists