Talc cleared of cancer link as cases to reopen

Grant Boone
January 9, 2020

A JAMA study of more than 250,000 women published today found no significant link between the use of powder in the genital area and risk of ovarian cancer among women. J&J says its powder is routinely tested to ensure it does not contain asbestos. The practice has been linked to ovarian cancer, with high-profile lawsuits in the United States against manufacturer Johnson & Johnson. Women with cancer are more likely to remember or mention something that could be linked to cancer than women without, meaning these studies could have biased results.

Such retrospective studies "can sometimes find links that do not exist", Susan Gapstur, senior vice president of Behavioral and Epidemiology Research at the American Cancer Society, said in an email.

"A lot of the retrospective studies identify women who have ovarian cancer and ask about exposures prior to their developing ovarian cancer", says O'Brien. "Thus, it is crucial to evaluate the talc-ovarian cancer association using prospective data".

A team of researchers with the National Institute of Environmental Health Sciences analyzed the data from four separate studies, which tracked more than 250,000 women over the course of ten years and found that 2,168 women developed ovarian cancer. The study was funded by the US National Institutes of Health and the National Cancer Institute.

Only a few reports, including The Independent, make clear that the study did not rule out a small increase in risk.

Healthcare giant Johnson & Johnson faces almost 17,000 lawsuits alleging that asbestos-contaminated talc-based personal care products have caused ovarian cancer and other malignant diseases in women.

What did the research involve?

When researchers looked at women who had used genital powder for long periods of time, or more frequently - questions that were asked in some but not all the component studies - there was also no evidence of a strong ovarian cancer risk. Of that 38%, 10% reported long-term use and the remaining 22% reported frequent use. There is a relationship between pelvic inflammatory disease and ovarian cancer, but more research is needed to draw any conclusion about this possible connection. The studies included data about women's health and lifestyles.

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What were the basic results?

The 252,745 eligible women in the studies were followed up for an average 11.2 years. That represents 58 cases for every 100,000 women per year. It also found that the estimated hazard ratio (HR) for frequent use versus never use was 1.09 (95% confidence interval [CI] 0.97-1.23), and the HR for long-term use versus never use was 1.01 (95% CI 0.82-1.25). That broke down to 61 cases per 100,000 person year's among those who had ever used talc around their genital areas and 55 cases per 100,000 person years among those who didn't. Any differences in the results between the groups of women were small enough to have come about by chance.

The researchers found hints of a potentially small increased risk for cancer for women who had never had a hysterectomy or fallopian tube-tying surgery.

This increase needs to be understood in context, she says.

"One of the primary drivers of research on genital use of talc-based products and ovarian cancer has been the potential link between talc and asbestos, which can occur together in nature", O'Brien's group wrote. That risk rose to 19% among women who used baby powders at least once a week. Although a small increase in risk can not be ruled out altogether, any increase is likely to be very small as it was not enough to show up in this study.

The study did not address the possibility of exposure by breathing powder into the lungs.

Most of the women from two of the cohorts were born between 1915 and 1944, and those from the other two were born in 1945 or later.

There is no particular need to use talc or any other product on the vulva for hygiene reasons, however. Washing with water is sufficient, and use of scented products can cause irritation to sensitive skin.

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