Talcum powder, chronic pelvic inflammation and NSAIDs in relation to risk of epithelial ovarian cancer

Authors

  • Melissa A. Merritt,

    1. Population Studies and Human Genetics Division, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
    2. School of Population Health, University of Queensland, Brisbane, Queensland, Australia
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  • Adèle C. Green,

    1. Population Studies and Human Genetics Division, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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  • Christina M. Nagle,

    1. Population Studies and Human Genetics Division, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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  • Penelope M. Webb

    Corresponding author
    1. Population Studies and Human Genetics Division, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
    • Queensland Institute of Medical Research, PO Royal Brisbane and Women's Hospital, Brisbane, Queensland 4029, Australia
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    • Fax: +61-7-3845-3502.


  • The Australian Ovarian Cancer Study Group comprises: Management Group: D Bowtell (Peter MacCallum Cancer Centre, PMCC), G Chenevix-Trench, A Green, P Webb (Queensland Institute of Medical Research, QIMR), A deFazio (Westmead Hospital), D Gertig (University of Melbourne). Project Managers: N Traficante (PMCC), S Moore (QIMR), J Hung (Westmead Hospital). Data Managers: S Fereday (PMCC), K Harrap, T Sadkowsky (QIMR). Research Nurses: NSW-A Mellon, R Robertson (John Hunter Hospital), T Vanden Bergh (Royal Hospital for Women), J Maidens (Royal North Shore Hospital), K Nattress (Royal Prince Alfred Hospital), YE Chiew, A Stenlake, H Sullivan, (Westmead Hospital); QLD-B Alexander, P Ashover, S Brown, T Corrish, L Green, L Jackman, K Martin, B Ranieri (QIMR); SA-J White (QIMR); TAS-V Jayde (Royal Hobart Hospital); VIC-L Bowes (PMCC), P Mamers (Monash Medical Centre), WA-T Schmidt, H Shirley, S Viduka, Hoa Tran, Sanela Bilic, Lydia Glavinas (Western Australia Research Tissue Network). Clinical Collaborators: NSW-A Proietto, S Braye, G Otton (John Hunter Hospital); T Bonaventura, J Stewart (Newcastle Mater Misericordiae); M Friedlander (Prince of Wales Hospital); D Bell, S Baron-Hay, A Ferrier, G Gard, D Nevell, B Young (until mid 2003) (Royal North Shore Hospital); C Camaris, R Crouch, L Edwards, N Hacker, D Marsden, G Robertson (Royal Hospital for Women); P Beale, J Beith, J Carter, C Dalrymple, A Hamilton, R Houghton, P Russell (Royal Prince Alfred Hospital); A Brand, R Jaworski, P Harnett, G Wain (Westmead Hospital); QLD-A Crandon, M Cummings, K Horwood. A Obermair, D Wyld (Royal Brisbane and Women's Hospital, RBWH); J Nicklin (RBWH and Wesley Hospital), L Perrin (RBWH and Mater Misericordiae Hospitals), B Ward (Mater Misericordiae Hospitals); SA-M Davy, C Hall, T Dodd, T Healy, K Pittman (Royal Adelaide Hospital, Burnside Memorial Hospital); D Henderson, S Hyde (Flinders Medical Centre); J Miller, J Pierdes (Queen Elizabeth Hospital); TAS-P Blomfield, D Challis, R McIntosh, A Parker (Royal Hobart Hospital); VIC-B Brown, R Rome (Freemasons Hospital); D Allen, P Grant, S Hyde, R Laurie M Robbie, (Mercy Hospital for Women), D Healy, T Jobling, T Maniolitas, J McNealage, P Rogers, B Susil, A Veitch, J Constable, S Ping Tong, I Robinson, I Simpson, (Monash Medical Centre); K Phillips, D Rischin, P Waring, M Loughrey, N O'Callaghan, Bill Murray (PMCC); V Billson, S Galloway, J Pyman, M Quinn (Royal Women's Hospital); WA-I Hammond, A McCartney, Y Leung (King Edward Memorial Hospital, St John of God). Scientific Collaborators: I Haviv (PMCC); D Purdie, D Whiteman (QIMR); N Zeps (WARTN); The Australian Cancer Study Group investigators are: AC Green, PG Parsons, N Hayward, P Webb, D Purdie and D Whiteman (QIMR).

Abstract

Chronic inflammation has been proposed as the possible causal mechanism that explains the observed association between certain risk factors, such as the use of talcum powder (talc) in the pelvic region and epithelial ovarian cancer. To address this issue we evaluated the potential role of chronic local ovarian inflammation in the development of the major subtypes of epithelial ovarian cancer. Factors potentially linked to ovarian inflammation were examined in an Australia-wide case–control study comprising 1,576 women with invasive and low malignant potential (LMP) ovarian tumours and 1,509 population-based controls. We confirmed a statistically significant increase in ovarian cancer risk associated with use of talc in the pelvic region (adjusted odds ratio 1.17, 95% CI: 1.01–1.36) that was strongest for the serous and endometrioid subtypes although the latter was not statistically significant (adjusted odds ratios 1.21, 95% CI 1.03–1.44 and 1.18, 95% CI 0.81–1.70, respectively). Other factors potentially associated with ovarian inflammation (pelvic inflammatory disease, human papilloma virus infection and mumps) were not associated with risk but, like others, we found an increased risk of endometrioid and clear cell ovarian cancer only among women with a history of endometriosis. Regular use of aspirin and other nonsteroidal anti-inflammatory drugs was inversely associated with risk of LMP mucinous ovarian tumours only. We conclude that on balance chronic inflammation does not play a major role in the development of ovarian cancer. © 2007 Wiley-Liss, Inc.

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