Abstract
Background
Most known endometrial cancer risk factors involve genetics or exposure to unopposed estrogens; less is known about risk due to environmental exposures. While several studies have found an increased risk of ovarian cancer associated with perineal powder use, only two studies have addressed perineal powder use and endometrial cancer risk.
Methods
We used Cox proportional hazards regression to examine the association between perineal powder use and endometrial cancer risk using the Women’s Health Initiative Observational Study Research Materials obtained from the National Heart, Lung, and Blood Institute Biological Specimen and Data Repository Coordinating Center.
Results
Of the 48,526 women in our primary analysis, 25,181 (52 %) reported ever use of perineal powder. During 364,134 person-years of follow-up, 447 participants were diagnosed with endometrial cancer. Ever use of perineal powder was not associated with increased risk of endometrial cancer (multivariable-adjusted hazard ratio, 1.06; 95 % confidence interval, 0.87–1.28). External use of powder on the genitals and/or on sanitary napkins was also not significantly associated with risk of endometrial cancer. However, use of powder on a diaphragm for twenty or more years was associated with a threefold increase in risk of endometrial cancer compared to women who never used perineal powder (multivariable-adjusted hazard ratio, 3.06; 95 % CI, 2.00–4.70).
Conclusions
Any duration of external use of perineal powder was not associated with increased risk of endometrial cancer; however, long-term use of powder on a diaphragm may increase the risk of endometrial cancer.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Cancer S (2012) Cancer facts & figures 2012. American Cancer Society, Inc., Atlanta
Huncharek M, Geschwind JF, Kupelnick B (2003) Perineal application of cosmetic talc and risk of invasive epithelial ovarian cancer: a meta-analysis of 11,933 subjects from sixteen observational studies. Anticancer Res 23(2C):1955–1960
Huncharek M, Muscat J, Onitilo A, Kupelnick B (2007) Use of cosmetic talc on contraceptive diaphragms and risk of ovarian cancer: a meta-analysis of nine observational studies. Eur J Cancer Prev 16(5):422–429. doi:10.1097/01.cej.0000236257.03394.4a
Karageorgi S, Gates MA, Hankinson SE, De Vivo I (2010) Perineal use of talcum powder and endometrial cancer risk. Cancer Epidemiol Biomarkers Prev 19(5):1269–1275. doi:10.1158/1055-9965.EPI-09-1221
Neill AS, Nagle CM, Spurdle AB, Webb PM (2012) Use of talcum powder and endometrial cancer risk. Cancer Causes Control 23(3):513–519. doi:10.1007/s10552-011-9894-5
Wild P (2006) Lung cancer risk and talc not containing asbestiform fibres: a review of the epidemiological evidence. Occup Environ Med 63(1):4–9. doi:10.1136/oem.2005.020750
Rohl AN, Langer AM, Selikoff IJ, Tordini A, Klimentidis R, Bowes DR, Skinner DL (1976) Consumer talcums and powders: mineral and chemical characterization. J Toxicol Environ Health 2(2):255–284. doi:10.1080/15287397609529432
Heller DS, Westhoff C, Gordon RE, Katz N (1996) The relationship between perineal cosmetic talc usage and ovarian talc particle burden. Am J Obstet Gynecol 174(5):1507–1510
Henderson WJ, Hamilton TC, Griffiths K (1979) Talc in normal and malignant ovarian tissue. Lancet 1(8114):499
Venter PF (1981) Ovarian epithelial cancer and chemical carcinogenesis. Gynecol Oncol 12(3):281–285
Cook LS, Kamb ML, Weiss NS (1997) Perineal powder exposure and the risk of ovarian cancer. Am J Epidemiol 145(5):459–465
Schins RP (2002) Mechanisms of genotoxicity of particles and fibers. Inhal Toxicol 14(1):57–78. doi:10.1080/089583701753338631
Dranoff G (2004) Cytokines in cancer pathogenesis and cancer therapy. Nat Rev Cancer 4(1):11–22. doi:10.1038/nrc1252
Mills PK, Riordan DG, Cress RD, Young HA (2004) Perineal talc exposure and epithelial ovarian cancer risk in the Central Valley of California. Int J Cancer 112(3):458–464. doi:10.1002/ijc.20434
Langer RD, White E, Lewis CE, Kotchen JM, Hendrix SL, Trevisan M (2003) The Women’s Health Initiative Observational Study: baseline characteristics of participants and reliability of baseline measures. Ann Epidemiol 13(9 Suppl):S107–S121
Curb JD, McTiernan A, Heckbert SR, Kooperberg C, Stanford J, Nevitt M, Johnson KC, Proulx-Burns L, Pastore L, Criqui M, Daugherty S (2003) Outcomes ascertainment and adjudication methods in the Women’s Health Initiative. Ann Epidemiol 13(9 Suppl):S122–S128
Rosenblatt KA, Mathews WA, Daling JR, Voigt LF, Malone K (1998) Characteristics of women who use perineal powders. Obstet Gynecol 92(5):753–756
Reeves KW, Carter GC, Rodabough RJ, Lane D, McNeeley SG, Stefanick ML, Paskett ED (2011) Obesity in relation to endometrial cancer risk and disease characteristics in the Women’s Health Initiative. Gynecol Oncol 121(2):376–382. doi:10.1016/j.ygyno.2011.01.027
Acknowledgments
This manuscript was prepared using the Women’s Health Initiative (WHI) Observational Study (OS) Research Materials obtained from the National Heart, Lung, and Blood Institute (NHLBI) Biologic Specimen and Data Repository Information Coordinating Center and does not necessarily reflect the opinions or views of the WHI OS or the NHLBI.
Conflict of interest
The authors declare no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Crawford, L., Reeves, K.W., Luisi, N. et al. Perineal powder use and risk of endometrial cancer in postmenopausal women. Cancer Causes Control 23, 1673–1680 (2012). https://doi.org/10.1007/s10552-012-0046-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-012-0046-3