Lifestyle and Environment · Environmental Exposures

Use of Straighteners and Other Hair Products and Incident Uterine Cancer

Chang CJ, O'Brien KM, Keil AP, Gaston SA, Jackson CL, Sandler DP, White AJ

Published December 8, 2022 Journal of the National Cancer Institute, 114(12), 1636-1645
DOI 10.1093/jnci/djac165 PMID 36245087 PMC PMC9949582

RRM Academy Synopsis

Hair straightener use is associated with higher uterine cancer rates

This study followed 33 947 US women for 10.9 years. Women who often used hair straighteners had a higher uterine cancer rate.

Key Findings

  • Use of straighteners more than 4 times in the 12 months before enrollment gave HR = 2.55 compared with no use (95% CI = 1.46 to 4.45; P trend = .002).
  • Women who used straighteners, relaxers or pressing products in the 12 months before enrollment had a higher uterine cancer rate than non-users (HR = 1.80, 95% CI = 1.12 to 2.88).
  • Predicted uterine cancer risk by age 70 years was approximately 1.64% without straightener use and an estimated 2.41% higher with frequent use (risk difference 95% CI = 0.52% to 4.80%).
  • Other hair products studied, such as permanent dyes and body waves, showed no association with the uterine cancer rate.
  • Follow-up averaged 10.9 years and produced 378 uterine cancer cases among 33 947 women aged 35-74 who still had a uterus at enrollment.

Interpretation

This cohort study followed women in the Sister Study, whose sisters had breast cancer. Women reported their hair product use in the 12 months before enrollment. Among ever users of straighteners, 59.9% were African American/Black. The higher rate remained evident among postmenopausal women and medically confirmed cases. The link was stronger with low physical activity. The authors note that brands and ingredients were not collected, so the chemicals involved remain unidentified. The findings support further study of hair products and uterine cancer.

RRM Context

Restorative reproductive medicine looks for the root causes of reproductive and hormonal problems. Exposures that act on hormones belong in that search. The authors name excess estrogen, and an imbalance of estrogen and progesterone, as key risk factors for uterine cancer.

Abstract

Background

Hair products may contain hazardous chemicals with endocrine-disrupting and carcinogenic properties. Previous studies have found hair product use to be associated with a higher risk of hormone-sensitive cancers including breast and ovarian cancer; however, to our knowledge, no previous study has investigated the relationship with uterine cancer.

Methods

We examined associations between hair product use and incident uterine cancer among 33 947 Sister Study participants aged 35-74 years who had a uterus at enrollment (2003-2009). In baseline questionnaires, participants in this large, racially and ethnically diverse prospective cohort self-reported their use of hair products in the prior 12 months, including hair dyes; straighteners, relaxers, or pressing products; and permanents or body waves. We estimated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) to quantify associations between hair product use and uterine cancer using Cox proportional hazard models. All statistical tests were 2-sided.

Results

Over an average of 10.9 years of follow-up, 378 uterine cancer cases were identified. Ever vs never use of straightening products in the previous 12 months was associated with higher incident uterine cancer rates (HR = 1.80, 95% CI = 1.12 to 2.88). The association was stronger when comparing frequent use (>4 times in the past 12 months) vs never use (HR = 2.55, 95% CI = 1.46 to 4.45; Ptrend = .002). Use of other hair products, including dyes and permanents or body waves, was not associated with incident uterine cancer.

Conclusion

These findings are the first epidemiologic evidence of association between use of straightening products and uterine cancer. More research is warranted to replicate our findings in other settings and to identify specific chemicals driving this observed association.

Topics

By this author

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Lifestyle and Environment › Environmental Exposures › Personal Care and Household Products · General Gynecology › Gynecologic Oncology › Endometrial Cancer
Che-Jung Chang, Katie M O'Brien, Alexander P Keil, Symielle A Gaston, Chandra L Jackson, Dale P Sandler, Alexandra J White
C Chang, Katherine O'Brien, K O'Brien, Alex Keil, A Keil, S Gaston, C Jackson, D Sandler, Alex White, A White
PMID 36245087 36245087 DOI 10.1093/jnci/djac165 10.1093/jnci/djac165 Chang et al. 2022, Chang 2022