Systematic review of the scientific evidence of the pulmonary carcinogenicity of talc.

We conducted a systematic review to assess the potential pulmonary carcinogenicity of inhaled talc in humans. Our systematic review methods adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and incorporated aspects from the US Institute of Medicine (IOM) and several United States (US) Environmental Protection Agency (EPA) frameworks for systematic reviews. A comprehensive literature search was conducted. Detailed data abstraction and study quality evaluation, adapting the US Toxic Substances Control Act (TSCA) framework, were central to our analysis. The literature search and selection process identified 23 primary studies that assessed exposure to talc and pulmonary cancer risks in humans ( n = 19) and animals ( n = 3). Integrating all streams of evidence according to the IOM framework yielded classifications of suggestive evidence of no association between inhaled talc and lung cancer and pleural mesothelioma at human-relevant exposure levels.
Competing Interests: Authors HL, KM, WT, DL, OL, JC, KC, RF, MC, AI, and AU are employed by Stantec ChemRisk, a consulting firm that provides scientific support to the government, corporations, law firms, and various scientific/professional organizations. Authors KM, WT, MC, and AI have been retained as expert witnesses on behalf of defendants in litigation matters in which it has been alleged that products containing talc caused mesothelioma or other cancers. Author PB is Full Professor at the Renaissance School of Medicine at Stony Brook University and Department of Medical and Surgical Sciences, University of Bologna, and Senior Scientific Advisor to ChemRisk; he has no conflicts to declare. The content and the conclusions of the manuscript are exclusively those of the authors.
(Copyright © 2022 Lynch, Lauer, Thompson, Leleck, Freid, Collins, Chen, Ierardi, Urban, Cappello, Boffetta and Mundt.)