Does Talcum Powder cause Cancer?
What's the Bottom Line?
Mixed. Some scientific studies suggest that the use of talcum powder near the genital area leads to increased risk of certain types of cancer (ovarian, endometrial). Other studies fail to demonstrate such a connection between talc use and cancer.
Let's take a closer look.
There are two basic types of studies that have been used to understand whether there is truly a connection between the perineal use of talcum powder and ovarian cancer. Most cohort studies fail to show a meaningful connection between talcum powder exposure and cancer while many case-control studies show such a connection. Cohort studies involve a large number of women (most of which do not have ovarian cancer) while case-control studies focus on women who have been diagnosed with ovarian cancer. There are many reasons why cohort studies could fail to show a connection when one actually exists and why case-control studies can show a connection when one does not really exist.
What's the Bottom Line?
In any environmental health and exposure scenario where a large number of scientific studies have been done and have produced mixed results, the safest course of action is to avoid exposure. Women should avoid the use of talcum powder on or near the genital area altogether. Legally, however, the many mixed results produced by the scientific community leave murky waters that reasonably should delay litigation until more conclusive evidence is available.
Cohort Studies
Cohort studies involve a larger number of people with similar characteristics who are tracked (observed) over a relatively long time period. Cohort studies that investigate the link between talc and cancer among women typically call for women to report their use (duration, frequency, or both) of talcum powder at one or more points in time and then, at a later point in time, these studies track incidences of ovarian cancer among these women.
Two of the larger cohort studies involving 78,630 women (Gertig et al., 2000) and 252,745 women (O'Brien et al., 2020) show no overall connection between the use of talcum powder and ovarian cancer. However, the Gertig (2000) study did show a significant increase in risk (40%) for certain types of ovarian cancers and this risk tended to increase with increasing use of talc.
Cohort studies often suffer from what is called in statistical terms -- low power. Low power refers to the fact that in these large cohorts, it is often the case that not enough people get the disease (or health problem) of interest to reach definitive conclusions about overall risk. Cohort studies can also be confused by confounding factors -- simultaneous exposures or behaviors that may be causing the disease of interest, either in connection with the exposure of interest (in this case, talc use) or independent of such exposure.
Case-Control Studies
Case-Control Studies ask people to recall their exposures to things in their environment after they have been identified as having a disease or other health problem. These "cases" are then compared to "controls" (similar individuals who do not have the disease).
A large number of case-control studies have been conducted and have found "a modest, but unusually consistent, excess in risk" of ovarian cancer (IARC, n.d.). These results remain consistent across different countries, different populations of women, and different time periods.
Case-Control studies are often vulnerable to recall bias (those who have the disease are often likely to over-report their exposure). Like Cohort studies, Case-Control studies can also be confused by confounding factors which are difficult to rule out in either type of study.
Additional Information
Another cohort study has shown that the use of talcum powder near the genital area increases the risk of endometrial cancer, especially for women who are postmenopausal (Karageorgi et al., 2010).
References
Gertig D.M., Hunter D.J., Cramer D.W. et al. (2000). Prospective study of talc use and ovarian cancer. J Natl Cancer Inst, 92:249–252. doi:10.1093/jnci/92.3.249. PMID:10655442.
IARC, International Agency for Research on Cancer (n.d.). Talc not containing asbestiform fibres, Monograph 14807-96-6. Available at: https://monographs.iarc.fr/wp-content/uploads/2018/06/mono93-8.pdf
Karageorgi, S., Gates, M. A., Hankinson, S. E., & De Vivo, I. (2010). Perineal use of talcum powder and endometrial cancer risk. Cancer Epidemiology and Prevention Biomarkers, 19(5), 1269-1275.
O’Brien, K. M., Tworoger, S. S., Harris, H. R., Anderson, G. L., Weinberg, C. R., Trabert, B., ... & Wentzensen, N. (2020). Association of powder use in the genital area with risk of ovarian cancer. Jama, 323(1), 49-59.
Mixed. Some scientific studies suggest that the use of talcum powder near the genital area leads to increased risk of certain types of cancer (ovarian, endometrial). Other studies fail to demonstrate such a connection between talc use and cancer.
Johnson and Johnson faces mounting legal battles over a potential link between the perineal (near the genitals) use of talcum powder among women and increased risk of ovarian cancer. The International Agency for Research on Cancer (IARC) has classified the perineal use of talcum powder as possibly carcinogenic to humans based on limited evidence from scientific studies that show a statistically significant link between the exposure and the cancer. While Johnson and Johnson continues to appeal and fight these cases in court, scientific research striving to prove or disprove the dangers of talc (baby) powder also continues. The combination of litigation, scientific studies, mixed results, and missing knowledge regarding how talcum powder enters and affects the body creates quite a tangled web of information.
Let's take a closer look.
There are two basic types of studies that have been used to understand whether there is truly a connection between the perineal use of talcum powder and ovarian cancer. Most cohort studies fail to show a meaningful connection between talcum powder exposure and cancer while many case-control studies show such a connection. Cohort studies involve a large number of women (most of which do not have ovarian cancer) while case-control studies focus on women who have been diagnosed with ovarian cancer. There are many reasons why cohort studies could fail to show a connection when one actually exists and why case-control studies can show a connection when one does not really exist.
What's the Bottom Line?
In any environmental health and exposure scenario where a large number of scientific studies have been done and have produced mixed results, the safest course of action is to avoid exposure. Women should avoid the use of talcum powder on or near the genital area altogether. Legally, however, the many mixed results produced by the scientific community leave murky waters that reasonably should delay litigation until more conclusive evidence is available.
Cohort Studies
Cohort studies involve a larger number of people with similar characteristics who are tracked (observed) over a relatively long time period. Cohort studies that investigate the link between talc and cancer among women typically call for women to report their use (duration, frequency, or both) of talcum powder at one or more points in time and then, at a later point in time, these studies track incidences of ovarian cancer among these women.
Two of the larger cohort studies involving 78,630 women (Gertig et al., 2000) and 252,745 women (O'Brien et al., 2020) show no overall connection between the use of talcum powder and ovarian cancer. However, the Gertig (2000) study did show a significant increase in risk (40%) for certain types of ovarian cancers and this risk tended to increase with increasing use of talc.
Cohort studies often suffer from what is called in statistical terms -- low power. Low power refers to the fact that in these large cohorts, it is often the case that not enough people get the disease (or health problem) of interest to reach definitive conclusions about overall risk. Cohort studies can also be confused by confounding factors -- simultaneous exposures or behaviors that may be causing the disease of interest, either in connection with the exposure of interest (in this case, talc use) or independent of such exposure.
Case-Control Studies
Case-Control Studies ask people to recall their exposures to things in their environment after they have been identified as having a disease or other health problem. These "cases" are then compared to "controls" (similar individuals who do not have the disease).
A large number of case-control studies have been conducted and have found "a modest, but unusually consistent, excess in risk" of ovarian cancer (IARC, n.d.). These results remain consistent across different countries, different populations of women, and different time periods.
Case-Control studies are often vulnerable to recall bias (those who have the disease are often likely to over-report their exposure). Like Cohort studies, Case-Control studies can also be confused by confounding factors which are difficult to rule out in either type of study.
Additional Information
Another cohort study has shown that the use of talcum powder near the genital area increases the risk of endometrial cancer, especially for women who are postmenopausal (Karageorgi et al., 2010).
References
Gertig D.M., Hunter D.J., Cramer D.W. et al. (2000). Prospective study of talc use and ovarian cancer. J Natl Cancer Inst, 92:249–252. doi:10.1093/jnci/92.3.249. PMID:10655442.
IARC, International Agency for Research on Cancer (n.d.). Talc not containing asbestiform fibres, Monograph 14807-96-6. Available at: https://monographs.iarc.fr/wp-content/uploads/2018/06/mono93-8.pdf
Karageorgi, S., Gates, M. A., Hankinson, S. E., & De Vivo, I. (2010). Perineal use of talcum powder and endometrial cancer risk. Cancer Epidemiology and Prevention Biomarkers, 19(5), 1269-1275.
O’Brien, K. M., Tworoger, S. S., Harris, H. R., Anderson, G. L., Weinberg, C. R., Trabert, B., ... & Wentzensen, N. (2020). Association of powder use in the genital area with risk of ovarian cancer. Jama, 323(1), 49-59.
Comments
Post a Comment