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JAMA. 2020 Jan 7;323(1):49-59. doi: 10.1001/jama.2019.20079.

Association of Powder Use in the Genital Area With Risk of Ovarian Cancer.

Author information

1
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
2
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
3
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
4
Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
5
Department of Epidemiology, School of Public Health, University of Washington, Seattle.
6
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
7
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
8
Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
9
Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville.
10
Social and Scientific Systems, Inc, Durham, North Carolina.
11
Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.

Abstract

Importance:

The relationship between use of powder in the genital area and ovarian cancer is not established. Positive associations reported in case-control studies have not been confirmed in cohort studies.

Objective:

To estimate the association between use of powder in the genital area and ovarian cancer using prospective observational data.

Design, Setting, and Participants:

Data were pooled from 4 large, US-based cohorts: Nurses' Health Study (enrollment 1976; follow-up 1982-2016; n = 81 869), Nurses' Health Study II (enrollment 1989; follow-up 2013-2017; n = 61 261), Sister Study (enrollment 2003-2009; follow-up 2003-2017; n = 40 647), and Women's Health Initiative Observational Study (enrollment 1993-1998; follow-up 1993-2017; n = 73 267).

Exposures:

Ever, long-term (≥20 years), and frequent (≥1/week) use of powder in the genital area.

Main Outcomes and Measures:

The primary analysis examined the association between ever use of powder in the genital area and self-reported incident ovarian cancer. Covariate-adjusted hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models.

Results:

The pooled sample included 252 745 women (median age at baseline, 57 years) with 38% self-reporting use of powder in the genital area. Ten percent reported long-term use, and 22% reported frequent use. During a median of 11.2 years of follow-up (3.8 million person-years at risk), 2168 women developed ovarian cancer (58 cases/100 000 person-years). Ovarian cancer incidence was 61 cases/100 000 person-years among ever users and 55 cases/100 000 person-years among never users (estimated risk difference at age 70 years, 0.09% [95% CI, -0.02% to 0.19%]; estimated HR, 1.08 [95% CI, 0.99 to 1.17]). The estimated HR for frequent vs never use was 1.09 (95% CI, 0.97 to 1.23) and for long-term vs never use, the HR was 1.01 (95% CI, 0.82 to 1.25). Subgroup analyses were conducted for 10 variables; the tests for heterogeneity were not statistically significant for any of these comparisons. While the estimated HR for the association between ever use of powder in the genital area and ovarian cancer risk among women with a patent reproductive tract was 1.13 (95% CI, 1.01 to 1.26), the P value for interaction comparing women with vs without patent reproductive tracts was .15.

Conclusions and Relevance:

In this analysis of pooled data from women in 4 US cohorts, there was not a statistically significant association between use of powder in the genital area and incident ovarian cancer. However, the study may have been underpowered to identify a small increase in risk.

PMID:
31910280
PMCID:
PMC6990816
DOI:
10.1001/jama.2019.20079
[Indexed for MEDLINE]
Free PMC Article

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