生殖颈腺石粉和冲洗是可能暴露于相关妇科癌症的化学物质的做法。然而，目前尚不清楚它们是否与肌瘤风险或女性肌瘤诊断年龄有关。我们评估了黑/非洲裔美国人和非西班牙裔白人女性早期青春期使用生殖颈腺石粉和冲洗对35岁之前和50岁之前已确诊的肌瘤的影响。数据来自Sister Study（2003-2020），这是一项纵向队列研究，涵盖了50884名35至74岁的美国女性，参与者被问及是否有肌瘤诊断及诊断年龄，并询问他们是否在10-13岁时或过去12个月使用过生殖颈腺石粉和/或进行过冲洗。在应用预定义的排除标准后，我们的分析样本大小为n=46,316（黑色n=4,310，NHW n=42,006）。多变量逻辑回归用于计算35至74岁在入组时已确诊的35岁之前诊断肌瘤与未诊断肌瘤的调整比值比（aOR）及95%的置信区间（CI），以及50至74岁在入组时已确诊的50岁之前诊断肌瘤与未诊断肌瘤的aOR和CI。我们进行了早期生活因素的调整（体内二乙基雌酚暴露、单胎或多胎、婴儿期喂养大豆配方），以及童年社会经济地位、相对体重和身高与10岁时同龄人的比较。我们使用了多重插补方法（在所有分析中缺失率<10%）。由于黑人女性较白人女性更有可能在年轻时发展肌瘤，所以结果按种族/族裔分层分析。在黑/非洲裔美国人女性中，有29%的人被确诊为35岁之前诊断的肌瘤。10-13岁时的生殖颈腺石粉使用（aOR = 1.23，CI：1.06-1.41）和冲洗（aOR = 1.19，95% CI：0.95-1.48）与35岁之前诊断的肌瘤患病几率更高相关。仅冲洗而不使用石粉未与患病几率增加相关，但生殖颈腺石粉和冲洗的联合使用与肌瘤有52%的增加患病几率的相关（CI：1.14-2.01）。在非西班牙裔白人女性中，有9%报告在35岁之前被诊断出肌瘤。10-13岁时的生殖颈腺石粉使用（1.31，1.20-1.44），但不是冲洗（0.96; 0.77-1.20），与35岁之前被诊断出肌瘤相关。当考虑50岁之前被诊断出的肌瘤时，我们在非西班牙裔白人女性中观察到了类似的模式，但这两种做法在黑人女性中与50岁之前的肌瘤诊断无关。青春期早期使用生殖颈腺石粉和与冲洗的联合使用，而不是单独冲洗，与黑/非洲裔美国人女性发病率高于35岁，以及非西班牙裔白人女性发病率高于35岁和50岁的患者相关。早期青春期可能是肌瘤发展的易感期，这表明应该教育青少年女孩避免使用石粉和冲洗，或寻找替代品。发表于Elsevier Inc.

Genital talc and douching are practices that can involve exposure to chemical compounds linked to certain gynecologic cancers. However, it is unclear if they are associated with fibroid risk or age at fibroid diagnosis among women.We evaluated the impact of early adolescence genital talc use and douching on prevalent fibroids diagnosed before age 35 and age 50 years among Black/African American and Non-Hispanic White women.Data were from the Sister Study (2003-2020), a prospective cohort of 50,884 U.S. women ages 35-74 years at enrollment. Participants were asked if they ever had a fibroid diagnosis and at what age, and if they used genital talc and/or douched between ages 10-13 years or in the past 12 months. After applying predefined exclusion criteria, our analytic sample size was n=46,316 (Black n=4310, NHW n=42,006). Multivariable logistic regression was used to compute adjusted odds ratio (aOR) and 95% confidence intervals (CI) for having vs. not having early onset fibroids diagnosed before age 35 among women 35-74 years old at enrollment, and fibroids diagnosed before age 50 among women 50-74 years old at enrollment. We adjusted for early life factors (in utero diethylstilbestrol exposure, singleton, or multiple birth, fed soy formular during infancy), and childhood socioeconomic status, relative weight and height compared to peers at age 10. We used multiple imputation (<10% missing in all analyses). Results were stratified by race/ethnicity given that Black women are more likely to develop fibroids at a younger age than NHW women.Among Black/African American women, 29% had fibroids diagnosed before age 35. Both genital talc use at age 10-13 (aOR=1.23, CI: 1.06-1.41) and douching (aOR=1.19, 95% CI: 0.95-1.48) were associated with higher odds of having a fibroid diagnosed before age 35. Douching without talc use was not associated with increased odds, but combined use of both genital talc and douche was associated with 52% increased odds of fibroids (CI: 1.14-2.01). Among non-Hispanic White women, 9% reported fibroids diagnosed before age 35. Genital talc use (1.31; 1.20-1.44), but not douching (0.96; 0.77-1.20) at ages 10-13 years was associated with having a fibroid diagnosed before age 35. We observed similar patterns for non-Hispanic White women when we considered fibroids diagnosed before age 50, but neither practice was associated with fibroids diagnosed before age 50 in Black women.Genital talc use in early adolescence and combined use with douching, but not douching alone, is associated with prevalent fibroids diagnosed before age 35 among Black/African American women and before ages 35 and 50 among non-Hispanic White women. Early adolescence may be a window of susceptibility for fibroid development, suggesting adolescent girls should be educated on abstention from or alternatives to talc and douching.Published by Elsevier Inc.