Perineal talc exposure and risk of ovarian carcinoma.

BACKGROUND: Clinical and epidemiologic studies have indicated the possible existence of an association between ovarian carcinoma and talcum powder use. Talc particles have been detected in histologic sections of ovarian carcinomas. It has also been demonstrated that inert particles travel from the perineum to the ovaries. Results from epidemiologic investigations have varied, from risks increased by twofold to no significant risk detected.

METHODS: A total of 450 patients with borderline and invasive ovarian carcinoma and 564 population controls in metropolitan Toronto and nearby areas of southern Ontario, Canada, were identified. These subjects were interviewed about their reproductive and menstrual histories as well as their exposure to dusting powders. Continuous unconditional logistic regression methods were used for analysis.

RESULTS: Exposure to talc, via sanitary napkins, direct application to the perineum, or both, was significantly associated with risk of ovarian carcinoma (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.08-1.86). A borderline-significant association was detected between duration of talc exposure and risk (OR 1.09, 95% CI 0.98-1.21, per 10 years of exposure). No significant association was found between frequency of exposure and risk. In comparing invasive and borderline carcinomas, risk remained elevated for both carcinoma types. Only risk for invasive carcinoma was statistically significant.

CONCLUSIONS: This investigation supports previous contentions that exposure to talc may increase risk of ovarian carcinoma. Questionable trends in duration and frequency of exposure suggest that further studies may be needed to clarify the role of talc in the etiology of this disease.