The Association Between Talc Use and Ovarian Cancer

Background: Multiple studies of ovarian cancer and genital talc use have led only to consensus about possible carcinogenicity. Seeking greater clarity, we examined this association in 2,041 cases with epi-thelial ovarian cancer and 2,100 age-and-residence-matched controls. Methods: We defined genital talc use as regular application to the geni-tal/rectal area directly, on sanitary napkins, tampons, or underwear. to estimate " talc-years, " we multiplied applications per year by years used. Unconditional logistic regression, Wald statistics, likelihood-ratio tests, and polytomous logistic regression were used to calculate adjusted odds ratios (Or) and 95% confidence intervals (ci), trends, effect-modification , and heterogeneity by ovarian cancer histologic subtype. Results: Overall, genital talc use was associated with an Or (95% ci) of 1.33 (1.16, 1.52), with a trend for increasing risk by talc-years. Women who used talc were more likely to be older, heavier, asthma sufferers, and regular analgesic users—none of which was a confounder. Dose–responses were more apparent for premenopausal women, especially nonsmokers and those heavier or postmenopausal users of menopausal hormones (hormone therapy [Ht]). Subtypes of ovarian cancer more likely to be associated with talc included invasive serous and endometrioid tumors and borderline serous and mucinous tumors. Premenopausal women and postmenopausal Ht users with these subtypes who had accumulated >24 talc-years had Ors (95% ci) of 2.