Feminine Hygiene Product Use and the Risk of Ovarian Cancer

Purpose: Ovarian cancer is a multifaceted disease with expression dependent upon accumulated risk factors over a lifetime. Until a reliable and valid general population screening test becomes available, it is essential that women are made aware of hereditary and lifestyle characteristics that increase their predisposition to ovarian cancer. Earlier detection with successful treatment is dependent on knowledge of predisposing risk and protective factors. Recent litigation against Johnson & Johnson has raised the question about the association between ovarian cancer and the use of body powder in the perineal area.

The research question addressed in this study was:  Is the use of feminine hygiene products associated with increased odds of developing ovarian cancer?

This question was derived from a larger overarching study to elicit data from women who have been diagnosed with ovarian cancer, as well as women who do not have the disease, to determine if there is clustering of ovarian cancer risk factors associated with the use of  genital talc, tampons, and douching.

Methods: A non-experimental, cross-sectional design utilizing online technology and snowball sampling. A priori power analysis determined minimum sample size to be 962-1188 participants for the desired level of power of .90 to .95, an α-level at .05, and a moderate effect size for the multiple logistic regression model using ROC curve analysis.

Results: 1,274 women completed the 25-minute online survey (553 women with ovarian cancer, 91 women with another cancer, 630 women with no cancer diagnosis). 80% of respondents were white women, 18 to 76 years of age (x=58) with at least a high school education. Crosstabuations with Pearson’s Chi Square and Logistic Regressions were used to examine the association between feminine hygiene use and having ovarian cancer. Among women who reported using douches, a greater proportion had ovarian cancer (33.1%) compared to those who did not (22.4%). Douching was significantly associated with increased odds of having ovarian cancer (Odds Ratio = 1.34). Among women who reported using talcum powder on their genital area, a greater proportion indicated having ovarian cancer (54.4%) compared to those who did not (39.9%).  Genital talcum use was also associated with increased likelihood of having ovarian cancer (Odds Ratio = 1.76).  Frequency of tampon use was not associated with ovarian cancer.

Conclusion: The use of body powder on the genital area and douching are associated with an increased incidence of ovarian cancer.  When both are used, there is additional risk of developing ovarian cancer.  No association between tampon use and ovarian cancer was identified in this study.  Ovarian cancer is a multifaceted disease with expression dependent upon accumulated risk factors over a lifetime. Understanding the relationships between genetic, biological, behavioral, developmental, and environmental factors is a first step in earlier detection of pathology. Recommendations for future research, public awareness campaigns, and the health care of women is contingent upon a more comprehensive model for identifying women at risk for developing ovarian cancer.