title: Perineal powder use and risk of ovarian cancer.
abstract: BACKGROUND
  Case-control studies have reported an increased risk of ovarian cancer among talc users; however, the only cohort study to date found no association except for an increase in serous invasive ovarian cancers. The purpose of this analysis was to assess perineal powder use and risk of ovarian cancer prospectively in the Women's Health Initiative Observational Study cohort.
  
  
  METHODS
  Perineal powder use was assessed at baseline by self-report regarding application to genitals, sanitary napkins, or diaphragms and duration of use. The primary outcome was self-reported ovarian cancer centrally adjudicated by physicians. Cox proportional hazard regression was used to estimate risk, adjusting for covariates, including person-time until diagnosis of ovarian cancer (n = 429), death, loss to follow-up, or September 17, 2012. All statistical tests were two-sided.
  
  
  RESULTS
  Among 61576 postmenopausal women, followed for a mean of 12.4 years without a history of cancer or bilateral oophorectomy, 52.6% reported ever using perineal powder. Ever use of perineal powder (hazard ratio [HR]adj = 1.06, 95% confidence interval [CI] = 0.87 to 1.28) was not associated with risk of ovarian cancer compared with never use. Individually, ever use of powder on the genitals (HRadj = 1.12, 95% CI = 0.92 to 1.36), sanitary napkins (HRadj = 0.95, 95% CI = 0.76 to 1.20), or diaphragms (HRadj = 0.92, 95% CI = 0.68 to 1.23) was not associated with risk of ovarian cancer compared with never use, nor were there associations with increasing durations of use. Estimates did not differ when stratified by age or tubal ligation status.
  
  
  CONCLUSIONS
  Based on our results, perineal powder use does not appear to influence ovarian cancer risk.
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Serena C
authors.initials: SC
authors.lastname: Houghton
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Reeves
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hankinson
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Lori
authors.initials: L
authors.lastname: Crawford
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Dorothy
authors.initials: D
authors.lastname: Lane
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Thomson
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO).
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA (SCH, KWR, SEH, LC, SRS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SEH); Department of Preventive Medicine, Stony Brook University School of Medicine, New York, NY (DL); Department of Social and Preventive Medicine, University at Buffalo, SUNY, Buffalo, NY (JWW); Health Promotion Sciences Division, College of Public Health and University of Arizona Cancer Center, Tucson, AZ (CAT); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA (JKO). ssturgeon@schoolph.umass.edu.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Sturgeon
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000139:chemically induced / Q000209:etiology*; D010502:Perineum; D011208:Powders / Q000009:adverse effects; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013627:Talc / Q000008:administration & dosage* / Q000009:adverse effects*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D016387:Women's Health
chemical_list: D011208:Powders; D013627:Talc