Genital use of talc and risk of ovarian cancer: A meta-Analysis

Some epidemiological studies suggest an association between genital use of talc powders and increased risk of ovarian cancer, but the evidence is not consistent. We performed a meta-Analysis of epidemiological studies to formally evaluate this suspected association. A systematic search was conducted in Medline, Embase, and Scopus, leading to the identification of 24 case-control studies and three cohort studies. In the meta-Analysis, we used a random-effect model to calculate summary estimates of the association between genital use of talc and occurrence of ovarian cancer. We assessed potential sources of betweenstudy heterogeneity and presence of publication bias. The summary relative risk (RR) for ever use of genital talc and ovarian cancer was 1.22 [95% confidence interval (CI): 1.13-1.30]. The RR for case-control studies was 1.26 (95% CI: 1.17-1.35) and for cohort studies was 1.02 (95% CI: 0.85-1.20, Pheterogeneity=0.007). Serous carcinoma was the only histologic type for which an association was detected (RR: 1.24; 95% CI: 1.15-1.34). There was a weak trend in RR with duration and frequency of genital talc use. This metaanalysis resulted in a weak but statistically significant association between genital use of talc and ovarian cancer, which appears to be limited to serous carcinoma with suggestion of dose-response. The heterogeneity of results by study design however, detracts from a causal interpretation of this association.