The association between douching, genital talc use, and the risk of prevalent and incident cervical cancer

Abstract

While human papillomavirus is the primary cause of cervical cancer, other factors may influence susceptibility and response to the virus. Candidates include douching and talcum powder applied in the genital area. We used Cox proportional hazards models to estimate confounder-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) in the Sister Study (2003–2009), a US cohort of women aged 35–74. We considered pre-baseline (n = 523) and incident (n = 31) cervical cancers. Douching at ages 10–13 was positively associated with pre-baseline cervical cancer (HR 1.32, 95% CI 0.86–2.03), though the association was not statistically significant. We did not observe an association between adolescent talc use and pre-baseline cervical cancer (HR 0.95, 95% CI 0.76–1.19). Douching in the year before enrollment was positively associated with incident cervical cancer (HR 2.56, 95% CI 1.10–5.99). The association between recent genital talc use and incident cervical cancer was positive, but not statistically significant (HR 1.79, 95% CI 0.78–4.11). The observed positive association between douching and incident cervical cancer is consistent with previous retrospective case–control studies. In the first study to examine genital talc use and cervical cancer, we did not see evidence of an association.