Body Powder and Ovarian Cancer Risk—What Is the Role of Recall Bias?

See related article by Schildkraut et al., p. 1411Ovarian cancer remains the most lethal gynecologic cancer, largely due to the poor prognosis of late-stage disease (1). Screening methods have proved to be largely ineffective (2, 3); thus, the identification of modifiable risk factors remains important for potentially reducing ovarian cancer mortality. Epidemiologic evidence implicates chronic inflammation as an important mechanism in the pathogenesis of ovarian cancer (4). Proinflammatory exposures associated with risk include increased number of lifetime ovulatory cycles, endometriosis, and pelvic inflammatory disease (4). Reduced risks for aspirin (5) suggest direct anti-inflammatory actions, whereas reduced risks with tubal ligation and hysterectomy may reflect limited exposure to environmental causes of inflammation via the fallopian tubes (4). Body powder use, specifically perineal talc use, has been suggested as another potential proinflammatory exposure that may be related to ovarian cancer risk.Several case–control studies have shown an association between genital powder use and increased risk of ovarian cancer (6–9). The International Agency for Research on Cancer classified genital talc use as