Talc exposure and risk of stomach cancer: Systematic review and meta-analysis of occupational cohort studies

Chang, Che-Jui; Tu, Yu–Kang; Chen, Pau‐Chung; Yang, Ya‐Chen

doi:10.1016/j.jfma.2018.07.015

Cited by 20 publications

(13 citation statements)

References 22 publications

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“…A recent meta-analysis of 40 mortality cohort studies showed that asbestos is associated with a moderately increased risk of stomach cancer [31]. A recent meta-analysis of 13 observational studies showed that occupational talc exposure is associated with an increased risk of stomach cancer [32]. A significant relationship has been found between occupational crystalline silica exposure and gastric cancer [33].…”

Section: Risk Factorsmentioning

confidence: 99%

Epidemiology of gastric cancer: global trends, risk factors and prevention

Rawla¹,

Barsouk²

2019

1,013

964

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Gastric cancer remains one of the most common and deadly cancers worldwide, especially among older males. Based on GLOBOCAN 2018 data, stomach cancer is the 5 th most common neoplasm and the 3 rd most deadly cancer, with an estimated 783,000 deaths in 2018. Gastric cancer incidence and mortality are highly variable by region and highly dependent on diet and Helicobacter pylori infection. While strides in preventing and treating H. pylori infection have decreased the overall incidence of gastric cancer, they have also contributed to an increase in the incidence of cardia gastric cancer, a rare subtype of the neoplasm that has grown 7-fold in the past decades. A better understanding of the etiology and risk factors of the disease can help reach a consensus in approaching H. pylori infection. Dietary modification, smoking cessation, and exercise hold promise in preventing gastric cancer, while genetic testing is enabling earlier diagnosis and thus greater survival.

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Section: Risk Factorsmentioning

confidence: 99%

Epidemiology of gastric cancer: global trends, risk factors and prevention

Rawla¹,

Barsouk²

2019

1,013

964

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“…The IARC has classified talc containing asbestos as “carcinogenic to humans” (group 1), inhaled talc without asbestos as "not classifiable as to carcinogenicity in humans" (group 3), and perineal talc application as possibly carcinogenic to humans (group 2B); however, ingested talc has not yet been evaluated. Our recent systemic review and meta-analysis showed that workers with occupational talc exposure had an increased standardized mortality ratios of 1.21 (95% CI: 1.03–1.42, p = 0.02) for stomach cancer [25]. In the subgroup analysis, however, our previous meta-analysis showed that workers exposed to talc without asbestos had a non-significantly increased SMR of 1.26 (95% CI: 0.97–1.63, p = 0.09), probably due to insufficient case number.…”

Section: Discussionmentioning

confidence: 99%

Stomach Cancer and Exposure to Talc Powder without Asbestos via Chinese Herbal Medicine: A Population-Based Cohort Study

Chang

Chen

Peng

et al. 2019

IJERPH

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The present investigation was designed to explore the risk of stomach cancer by oral intake of talc powder without asbestos. We conducted a population-based cohort study on a randomly sampled cohort from Taiwan’s health insurance database, with population of 1,000,000. The study participants were followed up through 2013. The outcome event of interest was the diagnosis of stomach cancer. The exposure of interest was the prescription of talc powder. Cox regression analyses were performed respectively. There were 584,077 persons without talc exposure and 21,575 talc users, 1849 diagnosed with stomach cancer. Persons with exposure of talc had a higher hazard ratio of stomach cancer (adjusted hazard ratio, 2.13; 95% confidence interval (CI), 1.54–2.94; p < 0.001). Classification by cumulative exposure of talc yielded adjusted hazard ratios of stomach cancer of 1.58 (95% CI, 0.79–3.17; p = 0.19) and 2.30 (95% CI, 1.48–3.57; p < 0.001) among persons with high (>21 g) and medium (6–21 g) exposure of talc, as compared to the low-exposure counterparts. Our data demonstrated positive association between increased risk of stomach cancer and oral intake of talc without asbestos. Despite the absence of dose-response effect, there might be a link between stomach cancer and talc.

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“…Other possible carcinogenic effects of talc have been discussed in the literature. A systematic review (Chang et al, 2020) showed a positive association between occupational talc exposure and risk of stomach cancer; however, the association with talc with no detectable level of asbestos was not significant.…”

Section: Introductionmentioning

confidence: 99%