title: Hair dye use and risk of fatal cancers in U.S. women.
abstract: BACKGROUND
  Permanent hair dyes are used by about one third of adult American women. Several epidemiologic studies associate hair dye use with increased risk of non-Hodgkin's lymphoma and multiple myeloma. In one study, risk increased with more prolonged exposure to darker, more concentrated, permanent dyes.
  
  
  OBJECTIVE
  The purpose of our study was to examine the relationship between hair dye use and development of certain cancers associated with hair dye use in previous studies.
  
  
  METHODS
  We examined prospectively the relationship between the use of permanent hair dyes and selected fatal cancers in 573,369 women. The participants provided information in 1982 on the frequency and duration of hair dye use and the color of hair dye used. Death rates were measured through 1989. Relative risks (RRs) were computed with subjects who had not used hair dyes serving as the referent group, and 95% confidence intervals (CIs) were calculated on the basis of approximate-variance formulas.
  
  
  RESULTS
  Women who had ever used permanent hair dyes showed decreased risk of all fatal cancers combined (RR = 0.93; 95% CI = 0.89-0.98) and of urinary system cancers (RR = 0.65; 95% CI = 0.49-0.87) and no increase in risk of any type of hematopoietic cancer. Women who had used black hair dyes for 20 years (0.6% of women hair dyers) or more had increased risk of fatal non-Hodgkin's lymphoma (RR = 4.37; 95% CI = 1.3-15.2) and multiple myeloma (RR = 4.39; 95% CI = 1.1-18.3). These positive findings are based on three cases of non-Hodgkin's lymphoma and two cases of multiple myeloma. We found no relationship between use of permanent hair dyes and fatal cancers of the mouth, breast, lung, bladder, or cervix, areas that were of interest as the result of earlier studies.
  
  
  CONCLUSIONS
  Women using permanent hair dyes are not generally at increased risk of fatal cancer. Women with prolonged use of dark, particularly black, hair dyes may have increased risk of fatal non-Hodgkin's lymphoma and multiple myeloma, but these women are a small fraction of hair dye users. Nonetheless, the removal of carcinogens from hair dyes and appropriate labeling of hair-coloring products would help reduce this potential risk.
authors.affiliation: American Cancer Society, Atlanta, GA 30329.
authors.forename: M J
authors.initials: MJ
authors.lastname: Thun
authors.forename: S F
authors.initials: SF
authors.lastname: Altekruse
authors.forename: M M
authors.initials: MM
authors.lastname: Namboodiri
authors.forename: E E
authors.initials: EE
authors.lastname: Calle
authors.forename: D G
authors.initials: DG
authors.lastname: Myers
authors.forename: C W
authors.initials: CW
authors.lastname: Heath
mesh_terms: D000328:Adult; D005260:Female; D006202:Hair Dyes / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000139:chemically induced* / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D006202:Hair Dyes