Perineal Talc Use and Ovarian Cancer: A Systematic Review and Meta-Analysis
A partir d'une revue systématique de la littérature (24 études cas-témoins incluant un total de 13 421 cas, 3 études de cohorte incluant un total de 890 cas), cette méta-analyse évalue l'association entre une utilisation de talc sur la zone génitale et le risque de développer un cancer de l'ovaire
Background: It has been posited that there is an association between perineal talc use and the incidence of ovarian cancer. To date, this has only been explored in observational studies. Objectives: To perform a meta-analysis to evaluate the association between perineal talc use and risk of ovarian cancer. Methods: Studies were identified using six electronic databases. Observational studies involving at least 50 cases of ovarian cancer were eligible for inclusion. We analyzed the association between ovarian cancer, including specific types, and any perineal talc use, long-term (>10 year) use, total lifetime applications, and use on diaphragms or sanitary napkins. A sub-group analysis was performed, stratifying by study design and population. Results: We identified 24 case-control (13421 cases) and three cohort studies (890 cases, 181 860 person-years). Any perineal talc use was associated with increased risk of ovarian cancer (OR=1.31, 95%CI 1.24-1.39). >3600 lifetime applications (OR=1.42, 95%CI 1.25-1.61) was slightly more associated with ovarian cancer than <3600 (OR=1.32, 95%CI 1.15-1.50). An association with ever use of talc was found in case-control studies (OR=1.35, 95%CI 1.27-1.43), but not cohort studies (OR=1.06, 95%CI 0.90-1.25). However, cohort studies found an association between talc use and invasive serous type ovarian cancer (OR=1.25, 95%CI 1.01-1.55). We found an increased risk of serous and endometrioid but not mucinous or clear cell subtypes. Conclusions: In general, there is a consistent association between perineal talc use and ovarian cancer. Some variation in the magnitude of the effect was found when considering study design and ovarian cancer subtype.
Epidemiology 2017