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"Emerging data show that use of permanent hair dyes, chemical relaxers, and straightening products might contribute to increased risk of hormone-related cancers (1-5) and potentially breast tumors with features indicative of more aggressive phenotypes (6). Given the wide use of these products globally, they are an important source of exposure to potentially harmful chemicals, including endocrine-disrupting chemicals—to which we are ubiquitously exposed (7)—and mutagenic and/or genotoxic compounds. The unequal burden of exposure across populations plausibly contributes to cancer inequities as the groups with the greatest exposure also experience poorer cancer outcomes (8). For example, Black women use more hair and menstrual and/or intimate products, and Latina and Hispanic women use more makeup and cosmetics compared with other race and ethnicity groups (9,10), thereby increasing their exposures to hormonally active chemicals. Likewise, Black women are disproportionately diagnosed with aggressive breast tumors (eg, triple-negative, inflammatory), aggressive ovarian tumors (eg, high-grade serous carcinoma), and aggressive types of uterine and endometrial cancers (eg, nonendometrioid carcinoma) and have lower 5-year survival rates and higher mortality rates for these cancers relative to White women (11)."


This is a pre-copy-editing, author-produced PDF of an article accepted for publication in JNCI: Journal of the National Cancer Institute in 2022 following peer review. This article may not exactly replicate the final published version. The definitive publisher-authenticated version is available online at

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Available for download on Tuesday, October 17, 2023