Talc Use in Genital Area Linked to Increased Risk for Ovarian Cancer

Cancer Epidemiol Biomarkers Prev. 2008; 17:2436-2444. Abstract


Regular use of talc in the genital area was significantly associated with an increased risk for ovarian cancer in a new analysis reported in the September issue of Cancer Epidemiology Biomarkers and Prevention. The researchers say that genital use of talc should be avoided.  This is not a new finding — the association between genital talc use and an increased risk for ovarian cancer has been reported previously.

"Physicians should ask the patient about talc use history and should advise the patient to discontinue using talc in the genital area if the patient has not already stopped."

"An alternative to talc is cornstarch powder, which has not been shown to increase ovarian cancer risk, or to forgo genital powder use altogether," she told Medscape Oncology.



No Risk From Talc Use Elsewhere on the Body



The latest findings come from an analysis of data from 2 separate study populations. Researchers obtained records for 1231 epithelial ovarian cancer cases and 1244 controls from the New England Case Control (NECC) study, and on 210 cases and 600 controls from the prospective Nurses' Health Study (NHS). In the questionnaire about talc use, "regular" use was defined as the application of powder to the genital/perineal region at least once a week.  Genital talc use was associated with an increased risk for ovarian cancer in both study populations. The relative risk for the association with regular talc use was 1.36 for total ovarian cancer and 1.60 for the serous invasive subtype.


Similar findings from the meta-analysis of 16 previous studies reported an approximately 30% increase in the risk for total epithelial ovarian cancer with regular genital exposure to talc (Anticancer Res. 2003;23:1955-1960).


"It is unclear whether talc applied to the perineum can reach the ovaries, although some studies have shown that inert particles can travel through the female genital tract to the fallopian tubes and ovaries, and others have found talc particles in ovarian tissue". They also note that some studies have shown that talc particles can induce an inflammatory response in vivo, whereas others have suggested an immune-mediated mechanism. It might be that exposure of the lower genital tract to talc is sufficient to cause changes, such as production of heat shock proteins, accumulation of talc in pelvic lymph nodes, or decreased levels of anti-MUCI antibodies, and these could lead to an increase in the risk for ovarian cancer.



Talc Classified as "Possible Human Carcinogen" International Agency for Research on Cancer, which works with the World Health Organization, has classified talc as a "possible human carcinogen."


Do talc particles actually reach the ovaries, or it is the contaminants in talc (asbestos and quartz) that are to blame, rather than the talc itself.


There are very few modifiable risk factors for ovarian cancer. The main one is the use of oral contraceptives, which has been clearly established to lower the risk for ovarian cancer. Others include tubal ligation, hysterectomy, and parity. Then there are factors that "probably" increase the risk for ovarian cancer, and this is where talc fits in, alongside asbestos, postmenopausal hormone therapy, and radiation.

 
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