Powder use in the genital area is not associated with an increased risk of ovarian cancer

Reference

O'Brien KM, Tworoger SS, Harris HR, et al. Association of powder use in the genital area with risk of ovarian cancer. JAMA 2020;323(1):49-59.

Synopsis

Most powder products include mineral talc, which may be carcinogenic. These investigators assessed data from 4 US-based cohorts including both Nurses' Health Studies (NHS and NHSII), the Sister Study (SIS), and the Women's Health Initiative Observational Study (WHI-OS). Participating women provided information via regular questionnaires on the use of powder in the gential area beginning in 1982 (NHS), 2013 (NHSII), 2003 (SIS), and 1993 (WHI-OS). Powder use included talcum powder, baby powder, or deodorizing powder that was either directly applied to the gential area or applied via sanitary napkins, tampons, diaphragms, cervical caps, or underwear. Other measured variables included frequency and length of use, as well as potential confounders. Incident cancer development was confirmed by reviewing medical records, a national death index, and pathology reports when available. Of the total cohort of 252,745 women, 39% self-reported the use of powder in the genital area, with 10% reporting long-term use (20 or more years) and 22% reporting frequent use (more than 5 times per week). During a median follow-up of 11.2 years, 2168 women (58 cases per 100,000 person-years) developed ovarian cancer. There was no significant difference in the incidence of ovarian cancer between ever users and never users of genital powder (61 vs 55 cases per 100,000 person-years, respectively; adjusted estimated risk difference at 70 years = 0.09%; 95% CI -0.02% to 0.19%). No significant differences occurred in risk on the basis of frequency or length of use, patency of reproductive tracts, race, age, menopausal status, hormone therapy use, body mass index, or parity.