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 Regular use of powder was associated with ovarian cancer regardless
of where the women used it, the researchers report. Users of genital
powder had more than a 40 percent increased risk of cancer, while
those who used only non-genital powder had an increased risk of more
than 30 percent.
“African-American women have been targeted for use of body powder,
and they use it more commonly,” principal investigator Joellen
Schildkraut told Reuters Health in a telephone interview. “I’ve
concluded – why use it?”
Schildkraut, an epidemiologist at the University of Virginia in
Charlottesville, had been skeptical of a long-debated connection
between genital talc and the deadly gynecologic cancer. But her new
study, in concert with other recent research, convinced her to
advise women to avoid using talcum powder.
“I was a cynic until these recent studies came out. As you look
across all these studies, I would say, why use it? It’s an avoidable
risk for ovarian cancer,” she said.
Schildkraut’s team interviewed 584 black women with ovarian cancer
and 745 black women without the disease from the southern, eastern
and midwestern U.S.
Nearly 63 percent of the women with ovarian cancer and nearly 53
percent of the healthy controls dusted themselves with powder, the
researchers report in Cancer Epidemiology.
Dr. Nicolas Wentzensen, head of clinical epidemiology for the
National Cancer Institute, noted that African-American women are
underrepresented in many epidemiological studies.
He told Reuters Health by email that Schildkraut’s research was
well-conducted and confirms previous studies describing an increased
risk of ovarian cancer from talc use.
Wentzensen noted that the current study found stronger associations
between talc use and ovarian cancer than previous research. A
December paper in the journal Epidemiology, for example, reported a
33 percent higher risk of ovarian cancer in women who said they
routinely applied talc to their crotches, sanitary napkins, tampon
and underwear.
In the past, African-American women have reported significantly
higher use of so-called feminine hygiene products, including genital
powder. A 2015 case-control study in Los Angeles found that 44
percent of African-American women reported using talcum powder,
compared to 30 percent of white women and 29 percent of Hispanic
women.
In the 1990s, Johnson and Johnson outlined a plan to hike flagging
sales of its powder “by targeting” black and Hispanic women,
according to a company memorandum made public in recent lawsuits
leading to multimillion-dollar verdicts against the powder
manufacturer.
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Prospective studies, which follow participants over time to see if
they develop a disease, are generally considered more reliable than
studies that look backward. Two prospective studies have failed to
link talc and ovarian cancer. But Schildkraut believes the
prospective studies included too few talc users and too few ovarian
cancer cases to uncover a relationship.
Because African-American women tend to use talc more, Schildkraut
believes that studying a sizable group of black women, like she did,
makes the study more powerful and might explain the stronger
association.
Wentzensen said recall bias, particularly following publicity about
outsized jury verdicts in talc-ovarian cancer cases, might explain
the stronger association in the new study. Schildkraut considered
recall bias but said she tends to believe women were more likely to
correctly remember their talc usage.
An estimated 20,000 American women are diagnosed with ovarian cancer
and about 14,500 die from it annually, according to the Centers for
Disease Control and Prevention (CDC).
Dr. Daniel W. Cramer, who heads the Obstetrics and Gynecology
Epidemiology Center at Brigham and Women’s Hospital in Boston, first
reported a link between genital talc and ovarian cancer in 1982.
Since then, he’s been calling for warning labels.
In a recent editorial in Gynecologic Oncology, cancer genetics
expert Dr. Steven Narod of Women’s College Research Institute in
Toronto wrote, “In the interests of public health, I believe we
should caution women against using genital talcum powder.”
Narod, who was not involved in Schildkraut’s study, wrote that it’s
“disingenuous to state that there is no evidence that talc is
associated with ovarian cancer.”
SOURCE: http://bit.ly/1RnMXzp Cancer Epidemiology, online May 12,
2016.
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