Possible morbidity in women from talc on condoms

Kasper, Candace S.

doi:10.1001/jama.273.11.846

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…Exposure to vaginal sprays or foams (Silver, 1994) was not associated with risk of ovarian cancer, though use may have been poorly recalled by older women. Talc from condoms (Kasper and Chandler, 1995) or diaphragms may be another peritoneal contaminant, but duration of exposure was not associated with ovarian malignancy in these data. However, use of talc in the perineal region was associated with a significant (30%) increase in risk of ovarian cancer.…”

Section: Surgical Tubal Occlusionmentioning

confidence: 56%

“…If tubal sterilisation or hysterectomy had been performed, women were asked about date and place of surgery and name of surgeon. Confirmation and details To test the theory that tubal occlusion prevents entry of foreign agents to the peritoneal cavity through the fallopian tubes, we assessed exposures to vaginal sprays, contraceptive foams and douches, possible talc lubricant on the surface of condoms (Kasper and Chandler, 1995) and talc used specifically in the perineal region. It also was postulated that if peritoneal irritants were to play a role in the development of epithelial ovarian cancers, then this would apply to primary peritoneal cancers in particular, with a consequent substantial reduction in risk to this sub-group after tubal occlusion.…”

Section: Methodsmentioning

confidence: 99%

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Tubal sterilisation, hysterectomy and decreased risk of ovarian cancer

et al. 1997

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We have examined the effect of tubal sterilisation and hysterectomy on risk of ovarian cancer in a large case-control study in eastern Australia involving 824 women aged 18-79 years, diagnosed with epithelial ovarian cancer between 1990 and 1993, and 855 controls randomly selected from the electoral roll. Relative risks for ovarian cancer were estimated using multiple categorical regression to adjust for age, parity, oral contraceptive use and other risk factors. Tubal sterilisation was associated with a 39% reduction in risk of ovarian cancer (RR 0.61, 95% CI 0.46-0.85) and hysterectomy with a 36% reduction (RR 0.64, 95% CI 0.48-0.85). Risk remained low 25 years after surgery and was reduced irrespective of sterilisation technique, and estimates were similar among various types of epithelial ovarian cancer. The greatest reduction (74%) was observed among women with primary peritoneal tumours. Pelvic infection and use of vaginal sprays or contraceptive foams were not related to ovarian cancer, while use of talc in the perineal region slightly but significantly increased risk among women with patent fallopian tubes. Reportedly heavy or painful menses, perhaps associated with retrograde flow, were associated with ovarian cancer, and reduction in risk of disease after hysterectomy was greatest among women who had heavy periods. Although the factors that cause epithelial ovarian cancer are unknown, there are several discretionary factors that appear to protect against it. Oral contraception is associated with up to 70% reduction in risk after 10 or more years of use compared with never-use (Purdie et al., 1995), the protection presumably reflecting long-term suppression of ovulation. A 30-50% reduction in risk has been observed (Booth et al., 1989;Hankinson et al., 1993;Irwin et al., 1991;Whittemore et al., 1992), though not consistently (Chen et al., 1992;Risch et al., 1994;Shu et al., 1989), after tubal sterilisation, and this is independent of childbearing and oralcontraceptive use. A similar inverse association is found between hysterectomy with ovarian conservation and ovarian cancer (Hankinson et al., 1993;Hartge et al., 1989;Irwin et al., 1991;Risch et al., 1994;Weiss and Harlow, 1986).Explanations include blocking the ascent into the peritoneal cavity (Woodruff, 1971) of carcinogenic agents such as talc (Henderson et al., 1979), asbestos (Graham and Graham, 1967), viruses (Wahlberg, 1994) or contraceptive foams or gels (Silver, 1994) through surgical closure of the fallopian tubes or postsurgical compromise of ovarian circulation (Cattanach, 1985) associated with decreased ovarian function. Alternatively, the negative associations between pelvic surgery and ovarian cancer may be secondary to sub-fertility (Mori et al., 1992) or may be the result of surveillance bias since women whose ovaries have been screened for malignancy during surgery will have a reduced risk of cancer for several years compared with women not screened in this manner (Weiss and Harlow, 1986). Available data are largely inconclusive a...

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Section: Surgical Tubal Occlusionmentioning

confidence: 56%

Section: Methodsmentioning

confidence: 99%

Tubal sterilisation, hysterectomy and decreased risk of ovarian cancer

et al. 1997

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“…The primary mode of talc exposure appeared to be direct application to the perineum. Although talc exposure via contraceptives such as condoms and diaphragms has been previously investigated,27 this type of behavior was rare in the current study population and therefore omitted from analyses. Overall, greater risk was associated with any regular talc exposure (OR 1.42, 95% CI 1.08‐1.86).…”

Section: Discussionmentioning

confidence: 99%

Perineal talc exposure and risk of ovarian carcinoma

Chang

Risch

1997

Cancer

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tence of an association between ovarian carcinoma and talcum powder use. Talc Harvey A. Risch, M.D., Ph.D.particles have been detected in histologic sections of ovarian carcinomas. It has also been demonstrated that inert particles travel from the perineum to the ovaries. Department of Epidemiology and Public Health,Results from epidemiologic investigations have varied, from risks increased by Yale University School of Medicine, New Haven, Connecticut.twofold to no significant risk detected. METHODS.A total of 450 patients with borderline and invasive ovarian carcinoma and 564 population controls in metropolitan Toronto and nearby areas of southern Ontario, Canada, were identified. These subjects were interviewed about their reproductive and menstrual histories as well as their exposure to dusting powders. Continuous unconditional logistic regression methods were used for analysis. RESULTS.Exposure to talc, via sanitary napkins, direct application to the perineum, or both, was significantly associated with risk of ovarian carcinoma (odds ratio been suspected as a lung and ovarian carcinogen. 2,6 Like asbestos, talc is a magnesium silicate. Pulverized talc, or talcum powder, is a

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“…Latex condoms have been manufactured with a wide variety of dusting powders including talc, starch, silica, and other minerals. The density of talc particles differs substantially by brands (Kasper and Chandler, 1995). Condom sales increased substantially in 1975, rising by about 10% annually until 1980 (Castleman, 1980).…”

Section: Exposure Via Barrier Condomsmentioning

confidence: 99%

“…This increase was attributed to a greater awareness of the health risks associated with older formulations of oral contraceptives and protection against sexually transmitted diseases including HIV infection. It was predicted in 1995 that the increase in condom use would increase the incidence of ovarian cancer in the United States if the talc in condoms was carcinogenic (Kasper and Chandler, 1995). The annual -0.9% decline in the age-adjusted surveillance, epidemiology and end results incidence of ovarian cancer since 1987 would appear to indicate that talc is not an ovarian carcinogen.…”

Section: Exposure Via Barrier Condomsmentioning

confidence: 99%

Perineal talc use and ovarian cancer: a critical review

Muscat

Huncharek

2008

European Journal of Cancer Prevention

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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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Possible morbidity in women from talc on condoms

Cited by 7 publications

References 5 publications

Tubal sterilisation, hysterectomy and decreased risk of ovarian cancer

Tubal sterilisation, hysterectomy and decreased risk of ovarian cancer

Perineal talc exposure and risk of ovarian carcinoma

Perineal talc use and ovarian cancer: a critical review

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