Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
J Natl Cancer Inst. 2014 Sep 10;106(9). doi: 10.1093/jnci/dju208. Print 2014 Sep.
Case-control studies have reported an increased risk of ovarian cancer among talc users; however, the only cohort study to date found no association except for an increase in serous invasive ovarian cancers. The purpose of this analysis was to assess perineal powder use and risk of ovarian cancer prospectively in the Women's Health Initiative Observational Study cohort.
Perineal powder use was assessed at baseline by self-report regarding application to genitals, sanitary napkins, or diaphragms and duration of use. The primary outcome was self-reported ovarian cancer centrally adjudicated by physicians. Cox proportional hazard regression was used to estimate risk, adjusting for covariates, including person-time until diagnosis of ovarian cancer (n = 429), death, loss to follow-up, or September 17, 2012. All statistical tests were two-sided.
Among 61576 postmenopausal women, followed for a mean of 12.4 years without a history of cancer or bilateral oophorectomy, 52.6% reported ever using perineal powder. Ever use of perineal powder (hazard ratio [HR]adj = 1.06, 95% confidence interval [CI] = 0.87 to 1.28) was not associated with risk of ovarian cancer compared with never use. Individually, ever use of powder on the genitals (HRadj = 1.12, 95% CI = 0.92 to 1.36), sanitary napkins (HRadj = 0.95, 95% CI = 0.76 to 1.20), or diaphragms (HRadj = 0.92, 95% CI = 0.68 to 1.23) was not associated with risk of ovarian cancer compared with never use, nor were there associations with increasing durations of use. Estimates did not differ when stratified by age or tubal ligation status.
Based on our results, perineal powder use does not appear to influence ovarian cancer risk.
病例对照研究报告称，滑石粉使用者卵巢癌风险增加；然而，迄今为止唯一的队列研究发现，除了浆液性浸润性卵巢癌的发病率增加外，两者并无关联。本分析的目的是前瞻性评估惠特尼倡议观察研究队列中会阴粉的使用与卵巢癌风险。
通过自我报告评估会阴粉的使用情况，报告内容包括将粉末涂于外阴、卫生棉条或子宫帽以及使用的持续时间。主要结局是由医生中心判定的自我报告的卵巢癌。使用 Cox 比例风险回归估计风险，调整协变量，包括卵巢癌诊断（n = 429）、死亡、失访或 2012 年 9 月 17 日之前的个人时间。所有统计检验均为双侧。
在 61576 名绝经后妇女中，平均随访 12.4 年，无癌症或双侧卵巢切除术病史，52.6%的人报告曾使用过会阴粉。与从未使用过会阴粉的女性相比，曾使用过会阴粉（风险比 [HR]adj = 1.06，95%置信区间 [CI] = 0.87 至 1.28）与卵巢癌风险无关。分别来看，曾将粉末涂于外阴（HRadj = 1.12，95%CI = 0.92 至 1.36）、卫生棉条（HRadj = 0.95，95%CI = 0.76 至 1.20）或子宫帽（HRadj = 0.92，95%CI = 0.68 至 1.23）与卵巢癌风险无关，使用时间的增加也与卵巢癌风险无关。按年龄或输卵管结扎状态分层时，估计值没有差异。
根据我们的结果，会阴粉的使用似乎不会影响卵巢癌的风险。
