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To the Editor: The meta-analysis of studies of hair dye use and cancer risk by Dr Takkouche and colleagues¹ was based on a comprehensive search of relevant studies of cancer risk associated with ever use, permanent dye use, and "intensive exposure," defined as more than 200 lifetime applications of hair dye. However, the article did not present data on risks related to hair dye color, duration of use (although duration was used to impute frequency when frequency was unavailable), or year of use. Since these data were not always available in individual studies, the meta-analysis presented only the variables that were provided by all studies. By limiting the review to the "lowest common denominator," valuable information was lost.

Of particular note are studies that have reported significantly elevated risks of non-Hodgkin lymphoma (NHL) associated with increasing duration of use, use of dark colors, and use before 1980.^2-4 Although the meta-analysis . . . [Full Text of this Article]

Shelia Hoar Zahm, ScD
zahms@mail.nih.gov

Joseph F. Fraumeni, Jr, MD
Division of Cancer Epidemiology and Genetics
National Cancer Institute
Rockville, Md

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