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Micha JP, Rettenmaier MA, Bohart R, Goldstein BH. Talc powder and ovarian cancer: what is the evidence? Arch Gynecol Obstet 2022; 306:931-933. [PMID: 35348830 DOI: 10.1007/s00404-022-06539-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Talc is a desiccant that has been historically used as baby powder by numerous women to enhance their feminine hygiene. Talc has been identified in proximity to asbestos; accordingly, retrospective and case-control studies have implicated the role of talc use in the development of ovarian cancer, whereas prospective evaluations have not documented concordant findings. Moreover, the positive associations derived from case-control studies have been remote and the putative causal factors remain inconclusive. Consequently, one should be circumspect regarding the assertion that genital talc powder application induces ovarian cancer development.
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Affiliation(s)
- John P Micha
- Women's Cancer Research Foundation, 699 Diamond Street, Laguna Beach, CA, USA
| | - Mark A Rettenmaier
- Women's Cancer Research Foundation, 699 Diamond Street, Laguna Beach, CA, USA
| | | | - Bram H Goldstein
- Women's Cancer Research Foundation, 699 Diamond Street, Laguna Beach, CA, USA.
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Letter to the Editor: Fletcher NM, Harper AK, Memaj I, Fan R, Morris RT, Saed GM. Molecular Basis Supporting the Association of Talcum Powder Use with Increased Risk of Ovarian Cancer. Reprod Sci. 2019;26(12):1603-12. DOI: 10.1177/1933719119831773. Reprod Sci 2020; 27:1834-1835. [PMID: 32813197 DOI: 10.1007/s43032-020-00265-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
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Goodman JE, Kerper LE, Prueitt RL, Marsh CM. A critical review of talc and ovarian cancer. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2020; 23:183-213. [PMID: 32401187 DOI: 10.1080/10937404.2020.1755402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The association between perineal talc use and ovarian cancer has been evaluated in several epidemiology studies. Some case-control studies reported weak positive associations, while other case-control and three large prospective cohort investigations found this association to be null. A weight-of-evidence evaluation was conducted of the epidemiology, toxicity, exposure, transport, in vitro, and mechanistic evidence to determine whether, collectively, these data support a causal association. Our review of the literature indicated that, while both case-control and cohort studies may be impacted by bias, the possibility of recall and other biases from the low participation rates and retrospective self-reporting of talc exposure cannot be ruled out for any of the case-control studies. The hypothesis that talc exposure induces ovarian cancer is only supported if one discounts the null results of the cohort studies and the fact that significant bias and/or confounding are likely reasons for the associations reported in some case-control investigations. In addition, one would need to ignore the evidence from animal experiments that show no marked association with cancer, in vitro and genotoxicity studies that did not indicate a carcinogenic mechanism of action for talc, and mechanistic and transport investigations that did not support the retrograde transport of talc to the ovaries. An alternative hypothesis that talc does not produce ovarian cancer, and that bias and confounding contribute the reported positive associations in case-control studies, is better supported by the evidence across all scientific disciplines. It is concluded that the evidence does not support a causal association between perineal talc use and ovarian cancer.
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Fiume MM, Boyer I, Bergfeld WF, Belsito DV, Hill RA, Klaassen CD, Liebler DC, Marks JG, Shank RC, Slaga TJ, Snyder PW, Andersen FA. Safety Assessment of Talc as Used in Cosmetics. Int J Toxicol 2015; 34:66S-129S. [DOI: 10.1177/1091581815586797] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Cosmetic Ingredient Review Expert Panel (Panel) assessed the safety of talc for use in cosmetics. The safety of talc has been the subject of much debate through the years, partly because the relationship between talc and asbestos is commonly misunderstood. Industry specifications state that cosmetic-grade talc must contain no detectable fibrous, asbestos minerals. Therefore, the large amount of available animal and clinical data the Panel relied on in assessing the safety of talc only included those studies on talc that did not contain asbestos. The Panel concluded that talc is safe for use in cosmetics in the present practices of use and concentration (some cosmetic products are entirely composed of talc). Talc should not be applied to the skin when the epidermal barrier is missing or significantly disrupted.
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Affiliation(s)
- Monice M. Fiume
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer, Washington, DC, USA
| | - Ivan Boyer
- Cosmetic Ingredient Review Senior Toxicologist, Washington, DC, USA
| | | | | | - Ronald A. Hill
- Cosmetic Ingredient Review Expert Panel Member, Washington, DC, USA
| | | | | | - James G. Marks
- Cosmetic Ingredient Review Expert Panel Member, Washington, DC, USA
| | - Ronald C. Shank
- Cosmetic Ingredient Review Expert Panel Member, Washington, DC, USA
| | - Thomas J. Slaga
- Cosmetic Ingredient Review Expert Panel Member, Washington, DC, USA
| | - Paul W. Snyder
- Cosmetic Ingredient Review Expert Panel Member, Washington, DC, USA
| | - F. Alan Andersen
- Former Director, Cosmetic Ingredient Review, Washington, DC, USA
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Yumrutas O, Kara M, Atilgan R, Kavak SB, Bozgeyik I, Sapmaz E. Application of talcum powder, trichloroacetic acid and silver nitrate in female rats for non-surgical sterilization: evaluation of the apoptotic pathway mRNA and miRNA genes. Int J Exp Pathol 2015; 96:111-5. [PMID: 25885949 DOI: 10.1111/iep.12123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/04/2015] [Indexed: 11/28/2022] Open
Abstract
There are several methods used for non-surgical sterilization in birth control including quinacrine, trichloroacetic acid (TCA), erythromycin, tetracycline, silver nitrate and talcum powder. Among these, talcum powder, TCA and silver nitrate are the most commonly used. However, the toxic and carcinogenic activities of these chemicals in ovarian tissue have been poorly elucidated. This study demonstrates the expression levels of antioxidant, apoptotic and anti-apoptotic genes after administration of talc powder, TCA and silver nitrate for non-surgical sterilization in female rat models. The expression changes of some microRNAs (miR-15b, miR-21, miR-34a and miR-98) that play key roles in the apoptosis pathway were also included. All expression analyses were evaluated with real-time PCR. The expression levels of all genes appeared to be upregulated in the talcum powder group, but the results were not statistically significant. Increased expression of Gsr and Sod1 genes was statistically significant in the talcum powder group. In TCA and silver nitrate group, expression of all genes was appeared to be elevated but only the Gsr expression was statistically significant in the TCA-administrated group; there were no statistically significant changes in the silver nitrate group. miRNA expression levels were increased in talcum powder and TCA-administrated groups, but these results were not significant. Expression levels of miR-15b, miR-21 and miR-98 in the silver nitrate group were significantly increased. Consequently, these chemicals appear to be non-carcinogenic agents for rat ovarian tissue which do not induce apoptosis. However, talcum powder and TCA can be considered as agents that are toxic to ovarian tissue.
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Affiliation(s)
- Onder Yumrutas
- Department of Medical Biology, Faculty of Medicine, University of Adiyaman, Adiyaman, Turkey
| | - Murat Kara
- Department of Medical Genetics, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Remzi Atilgan
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Firat, Elazıg, Turkey
| | - Salih Burcin Kavak
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Firat, Elazıg, Turkey
| | - Ibrahim Bozgeyik
- Department of Medical Biology, Faculty of Medicine, University of Adiyaman, Adiyaman, Turkey
| | - Ekrem Sapmaz
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Firat, Elazıg, Turkey
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Abstract
Talc, like asbestos, is a silicate that has been studied in relation to cancer risk. Several studies conducted over the past 25 years found an association between perineal talc powders and ovarian cancer. The summary relative risk is about 1.3 (95% confidence intervals 1.2-1.5) and these data have been interpreted as supporting a causal role. In this review article, we discuss the chemical and morphological features of talc and asbestos, and explain why despite their similar chemical classification talc does not possess asbestos-like carcinogenic properties. The heterogeneity in the perineal dusting studies has raised important concerns over the validity of the exposure measurements, and the lack of a consistent dose-response effect limits making causal inferences. Perhaps more importantly, whereas it is unknown whether external talc dust enters the female reproductive tract, measures of internal talc exposure such as talc-dusted diaphragms and latex condoms show no relationship with ovarian cancer risk. In addition, the therapeutic use of high dose cosmetic grade talc for pleurodesis has not been shown to cause cancer in patients receiving these treatment modalities. Talc is not genotoxic. Mechanistic, pathology and animal model studies have not found evidence for a carcinogenic effect. In summary, these data collectively do not indicate that cosmetic talc causes ovarian cancer.
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Cramer DW, Welch WR, Berkowitz RS, Godleski JJ. Presence of Talc in Pelvic Lymph Nodes of a Woman With Ovarian Cancer and Long-Term Genital Exposure to Cosmetic Talc. Obstet Gynecol 2007; 110:498-501. [PMID: 17666642 DOI: 10.1097/01.aog.0000262902.80861.a0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although epidemiologic studies suggest talc use may increase ovarian cancer risk, there is no proof that talc used externally reaches the pelvis. CASE A 68-year-old woman with stage III ovarian papillary serous carcinoma revealed she had used talc daily for 30 years to powder her genital area. Examination of her pelvic lymph nodes under polarized light microscopy showed diffuse areas of birefringence compatible with talc, confirmed by scanning electron microscopy and X-ray spectroscopy. CONCLUSION This description of talc in pelvic lymph nodes of a woman with ovarian cancer and decades of exposure to talc may prompt new studies and offer new insights into the biologic basis for the consistent, but debated, association between talc use and ovarian cancer.
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Affiliation(s)
- Daniel W Cramer
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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Gadducci A, Cosio S, Gargini A, Genazzani AR. Sex-steroid hormones, gonadotropin and ovarian carcinogenesis: a review of epidemiological and experimental data. Gynecol Endocrinol 2004; 19:216-28. [PMID: 15724805 DOI: 10.1080/09513590400014354] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- A Gadducci
- Department of Procreative Medicine and Child Development, Division of Gynecology and Obstetrics, University of Pisa, Italy
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