What is the story?
After the latest round of pay-outs Johnson & Johnson have been ordered to pay $4.7bn (£3.6bn) to women who claim their ovarian cancer was caused by using talcum powder. Ovarian Cancer Action investigates the facts behind this on-going legal case.
What does the evidence say?
There have been several studies that have looked at the possible link between talcum powder use and ovarian cancer. Some of the studies appear to show a modest increase in ovarian cancer risk in women who used talcum powder on their genitals, with one set of studies presented in 2003 showing a 33% increased risk in ovarian cancer in women who used the product in this way.
However, the reliability of these studies is questionable because they are all based on historical use of the product. This means the studies were done by taking two groups of women – one group who had ovarian cancer and one group who did not – and asking them about their previous talcum powder use. This retrospective approach relies very heavily on women remembering if they ever used talcum powder on their genitals and if so, how much they used, often needing to recall back many years. This could impact on the accuracy of the results the studies produced.
It is also important to bear in mind that women who have ovarian cancer may also be more likely to remember something like talcum powder use if they are aware of a potential link between the product and their disease. Whereas the participants who did not have ovarian cancer may not necessarily remember either way.
The most accurate way to determine if talcum powder is definitely a risk factor in ovarian cancer would be to observe over time women who do and do not use talcum powder on their genitals, and see if there is an increased prevalence of the disease in those who do compared to those who don’t. So far there has only been one of these prospective studies carried out. It looked at women’s talcum powder usage over a 20-year period and the results did not show an association between genital talcum powder use and overall risk of ovarian cancer.
Is there anything else to consider?
If something is going to lead to an increased risk of cancer logic and evidence tells us that the more a person uses or consumes it, the more at risk they become. For example, we know that smoking is a risk factor for lung cancer, and the more cigarettes someone smokes a day the more at risk they are of getting the disease.
Of the studies that found a positive association between genital talcum powder use and ovarian cancer, very few were able to find a relationship where increased use increased ovarian cancer risk further. So there is currently no evidence to suggest that more frequent talcum powder use puts women at any greater risk of developing ovarian cancer compared to someone who also uses it, but less frequently.
Talcum powder is often applied to the genital area in other ways, such as during contraceptive use. Diaphragms are often dusted in talc prior to use, meaning they come into much closer contact with the ovaries. A study published in 2007 did not find any association between talc-dusted diaphragms and ovarian cancer development.
So, what does this all mean?
Despite the pay-outs Johnson and Johnson are being ordered to make, there is not enough evidence to determine for sure if talcum powder use on a woman’s genitals is responsible for an increased risk of ovarian cancer.
The studies are few, and the results that are available from them are conflicting. This suggests that there needs to be much more research carried out in this area before it can be said with absolute confidence either way that talcum powder is a risk factor in ovarian cancer.
Ovarian Cancer Action recommends a safety-first approach to genital talcum powder use. There are no health or cleanliness benefits to using the product in this area, so we don’t recommend that it is used in this way. If you have been using talcum powder then do not panic. As discussed previously, where a possible increased risk has been observed is a third, which may sound significant but in reality, ovarian cancer is not a common disease, so we’re talking about the difference between a 2% risk and a 2.5% risk.
What are the current known risk factors for ovarian cancer?
There are a number of things that we know can affect a woman’s risk of getting ovarian cancer. These include family history and genetics, age, lifestyle and menstrual history. Our risk factors page of our website explains these risk factors in more detail.
We know that 15-20% of ovarian cancers are due to family history or a genetic mutation. To find out if your family history of cancer puts you at greater risk of getting cancer yourself, or of a carrying a risk increasing genetic mutation we have produced a Hereditary Cancer Risk Tool. This simple tool that assesses your risk of having inherited a genetic mutation that could increase your risk of developing certain cancers. It's suitable for both men and women.