Some epidemiological studies suggest an association between genital use of talc powders and increased risk of ovarian cancer, but the evidence is not consistent. We performed a meta-analysis of epidemiological studies to formally evaluate this suspected association. A systematic search was conducted in Medline, Embase, and Scopus, leading to the identification of 24 case–control studies and three cohort studies. In the meta-analysis, we used a random-effect model to calculate summary estimates of the association between genital use of talc and occurrence of ovarian cancer. We assessed potential sources of between-study heterogeneity and presence of publication bias. The summary relative risk (RR) for ever use of genital talc and ovarian cancer was 1.22 [95% confidence interval (CI): 1.13–1.30]. The RR for case–control studies was 1.26 (95% CI: 1.17–1.35) and for cohort studies was 1.02 (95% CI: 0.85–1.20, P heterogeneity=0.007). Serous carcinoma was the only histologic type for which an association was detected (RR: 1.24; 95% CI: 1.15–1.34). There was a weak trend in RR with duration and frequency of genital talc use. This meta-analysis resulted in a weak but statistically significant association between genital use of talc and ovarian cancer, which appears to be limited to serous carcinoma with suggestion of dose-response. The heterogeneity of results by study design however, detracts from a causal interpretation of this association.
aFaculty of Medicine, University of Dresden, Dresden, Germany
bRamboll Environ, Amherst, Massachusetts
cUniversity of South Florida College of Public Health, Tampa, Florida
dIcahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, USA
Correspondence to Paolo Boffetta, MD, MPH, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, One Gustave L. Levy Place, Box 1130, New York, NY 10029, USA Tel: +1 212 824 7378; fax: +1 212 849 2566; e-mail: email@example.com
Received August 31, 2016
Accepted December 20, 2016