Muscat Joshua E, Huncharek Michael S
Department of Health Evaluation Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Eur J Cancer Prev. 2008 Apr;17(2):139-46. doi: 10.1097/CEJ.0b013e32811080ef.
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.
滑石粉与石棉一样，是一种已针对癌症风险进行研究的硅酸盐。在过去25年中进行的多项研究发现，会阴用滑石粉与卵巢癌之间存在关联。汇总相对风险约为1.3（95%置信区间为1.2 - 1.5），这些数据被解释为支持因果关系。在这篇综述文章中，我们讨论了滑石粉和石棉的化学及形态特征，并解释了为何尽管它们化学分类相似，但滑石粉不具备石棉样的致癌特性。会阴撒粉研究中的异质性引发了对暴露测量有效性的重要担忧，且缺乏一致的剂量反应效应限制了因果推断。也许更重要的是，虽然尚不清楚外部滑石粉粉尘是否会进入女性生殖道，但内部滑石粉暴露的测量指标，如撒有滑石粉的子宫托和乳胶避孕套，与卵巢癌风险并无关联。此外，高剂量化妆品级滑石粉用于胸膜固定术的治疗用途，在接受这些治疗方式的患者中并未显示会导致癌症。滑石粉无基因毒性。机制、病理学和动物模型研究均未发现致癌作用的证据。总之，这些数据总体上并未表明化妆品级滑石粉会导致卵巢癌。
