Talc Exposure and Risk of Ovarian Cancer: A Systematic Review and Meta-Analysis with Limited Evidence on Cervical and...

Introduction: Talc, commonly used in products like baby powder and cosmetics, has been studied for a possible link to female genital cancers, especially ovarian cancer. However, evidence is inconclusive. We conducted a systematic review and meta-analysis to assess the association between talc exposure and the incidence and mortality of ovarian, cervical, and endometrial cancers, including ovarian cancer subtypes. Method: We searched MEDLINE (PubMed) and SCOPUS databases up to January 2026 for cohort and case-control studies. Studies were assessed for quality using a modified Newcastle-Ottawa Scale. Due to the nature of available data, meta-analysis was performed only on case-control studies on ovarian cancer, using a random-effects model. Publication bias was assessed through funnel plots and Egger's test, and a leave-one-out sensitivity analysis was performed. Stratified analyses were conducted based on geographic location, year of publication, exposure source, and tumor characteristics. Additionally, a two-stage dose-response meta-analysis was performed for ovarian cancer regarding frequency and duration of talc use. Results: Our review identified 37 studies related to ovarian cancer, one to cervical cancer, and six to endometrial cancer. Twenty-five case-control studies were included in the meta-analysis. Results showed a positive association between talc use and ovarian cancer risk (RR 1.32; 95% CI: 1.25-1.39), with stronger associations observed for women who applied talc directly to the genital area (RR 1.38) and those who used talc after bathing (RR 1.30). The risk was also higher for specific ovarian cancer subtypes, such as serous (RR 1.36) and endometrioid tumors (RR 1.35). No evidence of publication bias was found. Results of the pooled analysis of four cohort studies showed no association (RR for ever-use 1.08; 95% CI: 0.99-1.17, no trend according to duration or frequency of use). For cervical and endometrial cancers, no significant associations with talc exposure were observed. Conclusions: Case-control studies suggest a modest link between genital talc use and ovarian cancer risk, especially serous and endometrioid types. Cohort studies show no association, and no links were found for cervical or endometrial cancers. Accordingly, the results should be interpreted with caution, and the current evidence does not conclusively establish a causal relationship.