Researchers did not find a significantly higher risk for ovarian cancer in women who used powder in the genital area, according to an analysis of more than 250,000 women recently published in JAMA.
However, researchers noted that their study may have been underpowered to establish a small increase in ovarian cancer risk.
“Case-control studies have reported positive associations between ever use of powder in the genital area and ovarian cancer, with an estimated odds ratio of 1.24 in a pooled analysis and 1.31 in a meta-analysis,” Katie M. O'Brien, PhD, of the epidemiology branch of the National Institute of Environmental Health Sciences, and colleagues wrote. “However, these findings may be affected by recall bias, and a recent surge in talc-related lawsuits and media coverage has increased this possibility. Thus, it is crucial to evaluate the talc-ovarian cancer association using prospective data.”
Previous cohort studies exploring the association between powder use and ovarian cancer have yielded inconsistent results, according to researchers.
Researchers did not find a significantly higher risk for ovarian cancer in women who used powder in the genital area, according to an analysis of more than 250,000 women recently published in JAMA.
Source:Adobe
O’Brien and colleagues conducted a pooled analysis of data from 252,745 women (median age at baseline, 57 years) enrolled in four large cohorts: the Nurses’ Health Study, the Nurses’ Health Study II, the Sister Study and the Women’s Health Initiative Observational Study. Among them, 38% reported ever using powder in the genital area, 22% reported using powder in the genital area at least once a week and 10% reported long-term use of powder in the genital area for 20 years or more.
During a median of 11.2 years of follow up, the incidence of ovarian cancer was 61 cases per 100,000 person-years among women who ever used powder and 55 cases per 100,000 person-years among women who never used it (estimated HR = 1.08; 95% CI, 0.99-1.17). The estimated HR in women who used powder at least once a week vs. those who never used it was 1.09 (95% CI, 0.97-1.23), while the HR in women who used powder for 20 years or more vs. those who never used it was 1.01 (95% CI, 0.82-1.25).
There was no significant evidence of heterogeneity across the study cohorts. The researchers hypothesized that women with patent reproductive tracts may be more susceptible to the effects of powder on ovarian cancer. They reported finding a “possible positive association” of powder use in the genital area and ovarian cancer among women with patent reproductive tracts and no history of hysterectomy or tubal ligation (estimated HR = 1.13; 95% CI, 1.01-1.26). However, the association did not significantly differ from the association observed among women with nonpatent reproductive tracts, so the “finding should be considered only exploratory and hypothesis generating,” O'Brien and colleagues wrote.
“The main analysis included 2,168 ovarian cancer cases that developed over 3.8 million person-years. This far exceeds a previous meta-analysis of [previously] published ... results (890 cases over 182,000 person-years),” they concluded. “However, power to investigate links to peritoneal or fallopian tube cancers or histotypes other than serous was still low. Improvements in the classification of tumor types may contribute new insights, especially for fallopian tube cancers, which may be the true point of origin for most serous ovarian cancers.”
In a related editorial, Dana R. Gossett, MD, MSCI, of the department of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco, and Marcela G. del Carmen, MD, MPH, of the department of obstetrics, gynecology and reproductive biology at Harvard University Medical School, wrote that the O’Brien and colleagues’ findings should be “reassuring” to women who use or previously used powder in the genital area. They also offered a suggestion for additional research in this clinical area.
“Future analyses would be strengthened by focusing on women with intact reproductive tracts, with particular attention to timing and duration of exposure to powder in the genital area,” they wrote. “Accumulation of such data will take many years and given the low rates of current powder use among U.S. women, may not be feasible.”
Gossett and del Carmen concluded that “the rigorously conducted study by O’Brien [and colleagues] contributes important and timely data about the potential link between use of powder in the genital area and risk of ovarian cancer.” – by Janel Miller
Disclosures: Gossett reports a relationship with Bayer for expert consultancy services for the Mirena intrauterine device outside the submitted work. Please see the study and editorial for all other authors’ relevant financial disclosures.
Researchers did not find a significantly higher risk for ovarian cancer in women who used powder in the genital area, according to an analysis of more than 250,000 women recently published in JAMA.
However, researchers noted that their study may have been underpowered to establish a small increase in ovarian cancer risk.
“Case-control studies have reported positive associations between ever use of powder in the genital area and ovarian cancer, with an estimated odds ratio of 1.24 in a pooled analysis and 1.31 in a meta-analysis,” Katie M. O'Brien, PhD, of the epidemiology branch of the National Institute of Environmental Health Sciences, and colleagues wrote. “However, these findings may be affected by recall bias, and a recent surge in talc-related lawsuits and media coverage has increased this possibility. Thus, it is crucial to evaluate the talc-ovarian cancer association using prospective data.”
Previous cohort studies exploring the association between powder use and ovarian cancer have yielded inconsistent results, according to researchers.
Researchers did not find a significantly higher risk for ovarian cancer in women who used powder in the genital area, according to an analysis of more than 250,000 women recently published in JAMA.
Source:Adobe
O’Brien and colleagues conducted a pooled analysis of data from 252,745 women (median age at baseline, 57 years) enrolled in four large cohorts: the Nurses’ Health Study, the Nurses’ Health Study II, the Sister Study and the Women’s Health Initiative Observational Study. Among them, 38% reported ever using powder in the genital area, 22% reported using powder in the genital area at least once a week and 10% reported long-term use of powder in the genital area for 20 years or more.
During a median of 11.2 years of follow up, the incidence of ovarian cancer was 61 cases per 100,000 person-years among women who ever used powder and 55 cases per 100,000 person-years among women who never used it (estimated HR = 1.08; 95% CI, 0.99-1.17). The estimated HR in women who used powder at least once a week vs. those who never used it was 1.09 (95% CI, 0.97-1.23), while the HR in women who used powder for 20 years or more vs. those who never used it was 1.01 (95% CI, 0.82-1.25).
There was no significant evidence of heterogeneity across the study cohorts. The researchers hypothesized that women with patent reproductive tracts may be more susceptible to the effects of powder on ovarian cancer. They reported finding a “possible positive association” of powder use in the genital area and ovarian cancer among women with patent reproductive tracts and no history of hysterectomy or tubal ligation (estimated HR = 1.13; 95% CI, 1.01-1.26). However, the association did not significantly differ from the association observed among women with nonpatent reproductive tracts, so the “finding should be considered only exploratory and hypothesis generating,” O'Brien and colleagues wrote.
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“The main analysis included 2,168 ovarian cancer cases that developed over 3.8 million person-years. This far exceeds a previous meta-analysis of [previously] published ... results (890 cases over 182,000 person-years),” they concluded. “However, power to investigate links to peritoneal or fallopian tube cancers or histotypes other than serous was still low. Improvements in the classification of tumor types may contribute new insights, especially for fallopian tube cancers, which may be the true point of origin for most serous ovarian cancers.”
In a related editorial, Dana R. Gossett, MD, MSCI, of the department of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco, and Marcela G. del Carmen, MD, MPH, of the department of obstetrics, gynecology and reproductive biology at Harvard University Medical School, wrote that the O’Brien and colleagues’ findings should be “reassuring” to women who use or previously used powder in the genital area. They also offered a suggestion for additional research in this clinical area.
“Future analyses would be strengthened by focusing on women with intact reproductive tracts, with particular attention to timing and duration of exposure to powder in the genital area,” they wrote. “Accumulation of such data will take many years and given the low rates of current powder use among U.S. women, may not be feasible.”
Gossett and del Carmen concluded that “the rigorously conducted study by O’Brien [and colleagues] contributes important and timely data about the potential link between use of powder in the genital area and risk of ovarian cancer.” – by Janel Miller
Disclosures: Gossett reports a relationship with Bayer for expert consultancy services for the Mirena intrauterine device outside the submitted work. Please see the study and editorial for all other authors’ relevant financial disclosures.
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No significant link found between powder use, ovarian cancer - Healio
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