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Review
. 2023 Aug 7:5:1157761.
doi: 10.3389/ftox.2023.1157761. eCollection 2023.

Systematic review of the association between talc and female reproductive tract cancers

Heather N Lynch  1 , Daniel J Lauer  2 , Olivia Messina Leleck  3 , Rachel D Freid  1 , Justin Collins  4 , Kathleen Chen  4 , William J Thompson  1 , A Michael Ierardi  4 , Ania Urban  5 , Paolo Boffetta  6   7 , Kenneth A Mundt  1
Affiliations
Review

Systematic review of the association between talc and female reproductive tract cancers

Heather N Lynch et al. Front Toxicol. .

Abstract

Talc is a hydrous magnesium sheet silicate used in cosmetic powders, ceramics, paints, rubber, and many other products. We conducted a systematic review of the potential carcinogenicity of genitally applied talc in humans. Our systematic review methods adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and incorporated aspects from the US Institute of Medicine (IOM, now the National Academy of Medicine) and several US EPA frameworks for systematic reviews, evaluating and integrating the epidemiological, animal, and mechanistic literature on talc and cancer. We conducted a comprehensive literature search. Detailed data abstraction and study quality evaluation, adapting the Toxic Substances Control Act (TSCA) framework, were central to our analysis. The literature search and selection process identified 40 primary studies that assessed exposure to talc and female reproductive cancer risks in humans (n = 36) and animals (n = 4). The results of our evaluation emphasize the importance of considering biological plausibility and study quality in systematic review. Integrating all streams of evidence according to the IOM framework yielded classifications of suggestive evidence of no association between perineal application of talcum powders and risk of ovarian cancer at human-relevant exposure levels. We also concluded that there is suggestive evidence of no association between genital talc application and endometrial cancer, and insufficient evidence to determine whether a causal association exists between genital talc application and cervical cancer based on a smaller but largely null body of literature.

Keywords: hazard assessment; ovarian cancer; systematic review; talc; uterine cancer.

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Conflict of interest statement

HL, KM, WT, DL, OL, JC, KC, RF, AI, and AU are employed by Stantec ChemRisk, a consulting firm that provides scientific support to the government, corporations, law firms, and various scientific/professional organizations. PB is Professor, Department of Family, Population and Preventive Medicine, Renaissance School of Medicine at Stony Brook University and Associate Director for Population Sciences Stony Brook Cancer Center, and Senior Advisor to ChemRisk. The full content and the conclusions of this systematic review are exclusively those of the authors. Authors KM, WT, and AI have been retained as expert witnesses on behalf of defendants in litigation matters in which it has been alleged that products containing talc caused mesothelioma or other cancers. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Literature search and selection process.
FIGURE 2
FIGURE 2
Risk estimates for all ovarian cancer types for studies of “any” genital talcum powder use.
FIGURE 3
FIGURE 3
Heat map of study quality evaluation results for cohort studies of talc and ovarian cancer.
FIGURE 4
FIGURE 4
Heat map of study quality evaluation results for case-control studies of talc and ovarian cancer.
See this image and copyright information in PMC

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