This week, in a landmark ruling, cosmetics giant Johnson & Johnson was ordered to pay $72 million to the family of a woman who died of ovarian cancer allegedly linked to decades of using the company’s talcum-based body powders. The suit argued that J&J knowingly failed to warn consumers of a supposed cancer risk posed by using its Baby Powder and Shower to Shower products.
Although the company has now been put on the hook for what the court calls a conspiracy to defraud consumers, the science behind the claims doesn’t exactly sound the alarm bells.
Here’s what you need to know.
Whether or not you’ve heard it before, this question about talcum powder and ovarian cancer is nothing new—and the evidence supporting a link is not strong.
The talc found in talcum powder is a naturally occurring mineral mined from the earth. So is asbestos, a known carcinogen. They tend to be found in the same places, so some talc comes out contaminated with asbestos. Not all of it does, however (which is why the Occupational Safety & Health Administration lists them as two different substances: talc with asbestos and talc without asbestos), and it can be purified to have traces of asbestos removed.
It is well established that inhaling talc containing asbestos causes lung cancer. And in the 1960s and 70s people began to worry that using talcum powder might also lead to an increased risk of ovarian cancer.
The hypothetical how and why were never entirely clear, but the basic thought seemed to be that talc and asbestos were similar (and sometimes mixed up together), and that if you dusted your nether regions with talcum powder it could work its way up the vagina, past the cervix, through the uterus and along the fallopian tubes to the ovaries, where maybe it could somehow cause cancer.
“When I was in residency in 1979 there were questions about this,” Mary Jane Minkin, M.D., clinical professor of obstetrics and gynecology at Yale Medical School, tells SELF. “This is an old issue. And if you look at the literature, there is some data that shows slight increased risk and some data that doesn’t. It’s very shaky data.”
All in all, there’s no conclusive evidence for a causal relationship. A lot of research has found there is no reliable link between talc use and ovarian cancer incidence. And studies that have shown an increased risk are limited in a lot of ways. For instance, there’s not a solid scientific way to measure how much powder one woman uses on herself over her lifetime versus another, or how much talc is actually in that powder. And there are so many other factors that could be at play; consider, Minkin suggests, an overweight woman who uses powder between her legs to minimize chafing and absorb moisture. If she develops ovarian cancer, one could point to the talc, but obesity is itself a known risk factor.
When all the research is taken together, experts tend to agree that there really isn’t anything to worry about.
“Despite an observed association, several decades of medical research do not support the hypothesis that use of talcum powder causes ovarian cancer,” Hal C. Lawrence, III, M.D., executive vice president of the American Congress of Obstetricians and Gynecologists, tells SELF. “Because of concerns regarding potential discomfort or pain, obstetrician-gynecologists do not recommend use of vaginal treatments such as douche, vaginal sprays or talcum powder. However, there is no medical consensus that talcum powder causes cancer, including ovarian cancer.”
The American Cancer Society asserts that in studies investigating the link between talcum powder and cancer of the ovary, “findings have been mixed,” and that the types of studies that have reported a slightly increased risk tend to be biased because they rely on a person’s memory of product use in the past. The ACS assessment concludes, “For any individual woman, if there is an increased risk, the overall increase is likely to very be small. Still, talc is widely used in many products, so it is important to determine if the increased risk is real. Research in this area continues.”
If you find the whole asbestos thing disconcerting, that’s understandable, but also probably not worth getting worked up about. Consumer products specifically don’t use talc that contains asbestos. (The danger is still real for miners, though, who can be exposed to it during excavation.)
Companies don’t have to get their products cleared with the FDA before putting them on the market, but since safety questions still come up, the FDA took it upon itself a few years back to test a bunch of consumer talc products for asbestos.
“Published scientific literature going back to the 1960s has suggested a possible association between the use of powders containing talc and the incidence of ovarian cancer. However, these studies have not conclusively demonstrated such a link, or if such a link existed, what risk factors might be involved. Nevertheless, questions about the potential contamination of talc with asbestos have been raised since the 1970s,” the administration wrote on its website.
“Because safety questions about the possible presence of asbestos in talc are raised periodically, FDA decided to conduct an exploratory survey of currently marketed cosmetic-grade raw material talc, as well as some cosmetic products containing talc.”
Out of 34 eye shadows, blushes, pressed powders, foundations and body powders (including Johnson’s Baby Powder and Shower to Shower) the FDA tested, none showed any traces of asbestos.
If this is the first time you’ve heard about the talc-cancer question, you can pretty much bet it won’t be the last.
The J&J ruling was a bit of a shock to those in the know, and could end up making women freak out about something that’s neither new nor proven.
“I was truly quite surprised to hear about this because this is not news,” says Minkin. “This is something that has been discussed for years and there’s no smoking gun here.”
Jill Whyte, M.D., a gynecologic oncologist at Northwell Health Cancer Institute, tells SELF she was also “very surprised at this verdict putting fault with use of talc powder.”
For its part, Johnson & Johnson stands by the safety of its products. In a statement provided to SELF, the company said:
“The talc used in all our global products is carefully selected and meets the highest quality, purity and compliance standards. The recent jury outcome goes against decades of sound science proving the safety of talc as a cosmetic ingredient in multiple products, and while we sympathize with the family of the plaintiff, we strongly disagree with the outcome.”
Yet, the massive payout awarded by the jury sets a meaningful precedent for similar suits—there are 131 pending against J&J in New Jersey, Reuters cites another 1,000 in Missouri, where the current case was filed, and lawyers are hungrily searching for potential plaintiffs across the 50 states.
At the end of the day, if this still makes you nervous, there’s an easy answer: Just don’t use talcum powder in your crotch.
To echo Dr. Lawrence of the ACOG, most gyns don’t recommend using anything in the way of cosmetics around the genitals. But if you really want to use powder and are worried about talc, you could opt for products that use cornstarch instead.
“I generally advise patients that while there is no conclusive evidence that talc powder increases the risk of ovarian cancer, these type of associations are really difficult to study. They require looking at large groups of women over many years,” Whyte says. “Women may want to consider using a cornstarch-based powder instead of a talcum powder as there is absolutely no evidence linking cornstarch based powders with any form of cancer.”
But she stresses that “it is always important to put risk into perspective. It is important that gynecologists discuss the known risks for ovarian cancer with women during routine surveillance visits—things like family history of breast and/or ovarian cancer, increasing age, never having children, obesity and endometriosis. It is equally important to discuss factors that we know decrease the risk for ovarian cancer, most importantly long-term use of birth control pills.”
Read this article, published on SELF, by clicking here.