Does talcum powder cause ovarian cancer? – Washington Post

 In Health
A woman with ovarian cancer has been awarded a record-setting $417 million in a liability lawsuit against Johnson & Johnson after a jury agreed her cancer was caused by the company’s talcum powder. (Reuters)

Does talcum powder cause ovarian cancer?

A Los Angeles jury thinks so. This week it ordered Johnson & Johnson to pay $417 million to 63-year-old Eva Echeverria. She blamed her terminal illness on Johnson’s Baby Powder, which she used for decades starting at age 11. The company should have warned consumers about the risk, she argued.

The jury award is the biggest yet against Johnson & Johnson, which has lost most of a half-dozen trials involving claims its baby powder and Shower to Shower powder cause ovarian cancer. The company denies there’s a connection between its products and the disease and quickly said it would appeal the Los Angeles verdict. Lawsuits involving thousands more plaintiffs are pending.

Medical and cancer experts divide sharply on talc’s role. Some are convinced the powder is linked to an increased risk of ovarian cancer. Others, including government health experts, say the evidence is lacking.

“The scientific body of literature is not compelling at this time to support a strong association between talcum powder and ovarian cancer, let alone to say any one specific case was associated with powder,” said Amanda Fader, a gynecologic oncologist at Johns Hopkins University who was not involved in the studies.

The American Cancer Society says studies on talcum powder and ovarian cancer “have been mixed, with some studies reporting a slightly increased risk and some reporting no increase … For any individual woman, if there is an increased risk, the overall increase is likely to be very small.”

The National Cancer Institute (NCI) concludes “the weight of evidence does not support an association between perineal talc exposure and an increased risk of ovarian cancer.”

Yet Fader and others aren’t ruling out the possibility that a link might someday be established. The Food and Drug Administration, which says it has found no link, is doing additional research on the topic.

Talc, a mineral composed of magnesium, silicon, oxygen and hydrogen, is used extensively in cosmetics and personal care products. Women sometimes use talcum powder on their genital areas, sanitary napkins or diaphragms to absorb moisture and odor — contrary to the guidance of most physicians. (Asbestos, which has been linked to lung cancer, used to turn up as an impurity in talc, but it has been banned for several decades.) 

Many pediatricians also discourage the use of such powder on babies because the particles can cause breathing problems, according to Jennifer Lowry, a pediatrician and environmental health expert at Children’s Mercy Hospital in Kansas City.   

More than 22,000 women in the United States will be diagnosed with ovarian cancer this year, and 14,000 will die. The biggest risk factors, all well established, include a family history of breast or ovarian cancer, mutations in the BRCA genes and age.

The debate over talc began decades ago. In the early 1970s, scientists discovered talc particles in ovarian tumors. In 1982, Harvard researcher Daniel Cramer reported a link between talcum powder and ovarian cancer. His study was followed by several more finding an increased risk of ovarian cancer among regular users of talcum powder. Cramer, who at one point advised J&J to put a warning on its products, has become a frequent expert witness for women suing the company.

His studies and the many others that found a relationship used a case-control approach: A group of women diagnosed with ovarian cancer and a group without it were asked to recall their past diet and activities, and the results were then compared.

Critics say these kinds of studies have serious drawbacks, particularly “recall bias.” Women may forget what they did or, if diagnosed with cancer, might inadvertently overestimate their use of a suspect substance. People without a serious disease may be less motivated to remember details.

Three other studies — considered cohort studies — did not find any overall link. Unlike the case-control studies, these efforts began with a large group of women who did not have cancer and followed the progress of their health, with participants recording what they were doing in real time. The results of this approach, most scientists say, are stronger because they aren’t subject to the vagaries of memory.

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