Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Int J Cancer. 2021 Jun 1;148(11):2692-2701. doi: 10.1002/ijc.33470. Epub 2021 Feb 1.
When powder is applied to the genital area, it has the potential to reach internal reproductive organs and promote carcinogenesis by irritating and inflaming exposed tissues. Although many studies have considered the association between genital powder use and ovarian cancer risk, the relationship between genital powder use and uterine cancer is less well-studied. We pooled data from four large, prospective cohorts (the Nurses' Health Study, the Nurses' Health Study II, the Sister Study and the Women's Health Initiative - Observational Study). We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for prespecified confounders. In total, 209 185 women were included, with 37% reporting ever genital powder use. Over a mean 14.5 years of follow-up, 3272 invasive uterine cancers were diagnosed. There was no overall association between ever genital powder use and uterine cancer (HR = 1.01, 95% CI: 0.94-1.09), with little difference observed for frequent (≥1 times/week) vs never use (HR = 1.05, 95% CI: 0.95-1.16; P-for-trend = .46). Long-term use (>20 years; HR = 1.12, 95% CI: 0.96-1.31; P-for-trend = 0.14) was associated with a small, but not statistically significant, increase in risk, compared to never use. There were not clear differences by uterine cancer histologic subtypes or across strata of relevant covariates, including race/ethnicity, follow-up time, menopausal status and body mass index. The results of this large, pooled analysis do not support a relationship between the use of genital powder and uterine cancer, although the positive associations observed for long-term use may merit further consideration.
当粉末涂抹于生殖器区域时，它有可能刺激和炎症暴露的组织，进而进入内部生殖器官并促进癌变。虽然许多研究都考虑了生殖器粉末使用与卵巢癌风险之间的关联，但生殖器粉末使用与子宫癌之间的关系研究较少。我们汇集了四项大型前瞻性队列研究（护士健康研究、护士健康研究 II、姐妹研究和妇女健康倡议观察性研究）的数据。我们使用 Cox 比例风险模型来估计危害比（HR）和 95%置信区间（CI），并调整了预先指定的混杂因素。总共有 209185 名女性入组，其中 37%报告有过生殖器粉末使用史。在平均 14.5 年的随访期间，诊断出 3272 例浸润性子宫癌。总体而言，生殖器粉末使用与子宫癌之间没有关联（HR = 1.01，95%CI：0.94-1.09），频繁（≥1 次/周）与从不使用（HR = 1.05，95%CI：0.95-1.16；P 趋势 =.46）之间也没有差异。与从不使用相比，长期使用（>20 年；HR = 1.12，95%CI：0.96-1.31；P 趋势 = 0.14）与风险略有增加相关，但无统计学意义。在子宫癌组织学亚型或相关协变量（包括种族/民族、随访时间、绝经状态和体重指数）的各个分层中，没有明显差异。这项大型的汇集分析结果不支持生殖器粉末使用与子宫癌之间存在关系，尽管长期使用的阳性关联可能需要进一步考虑。
