What Role Does Talcum Powder Play in the Development of Ovarian Cancer?

Does talcum powder cause cancer? At least 13.000 people who have sued talc-based product manufacturer Johnson & Johnson in the United States think so. So far, however, juries and scientists have not reached a consensus. In March 2019, a New Jersey jury ruled on a case brought by 1 person alleging that a baby powder manufacturer caused their mesothelioma, reaching a verdict against the patient. Meanwhile, a Missouri court held Johnson & Johnson responsible for ovarian cancer in 22 women and ordered the company to pay $4.69 billion. In one case the company lost, a patient with ovarian cancer had used talcum powder for more than 20 years to keep her groin area dry where excess weight had caused chafing.

This question now occupies considerable scientific attention. Wayne State University researcher Dr. Ghassan Saed, like millions of women applying talcum powder to the genital (groin) area, had thought that the clay mineral often used alongside cornstarch in powder was chemically inert and harmless.

However, in new research presented at the 2019 Annual Meeting of the Society of Gynecologic Oncology, Dr. Saed's team demonstrated a link between talcum powder and inflammation in normal and ovarian cancer cells. Specifically, the researchers identified the mechanism involving the CAT, NOS and GPX1 genes by which powder stimulates mutations . Dr. Saed, an associate professor of obstetrics, gynecology and cell biology, says: "I went to the laboratory, took the powder and added it to ovarian cancer cell lines. We found that it increased oxidative stress in the cells." Surprisingly, they found that healthy fallopian tube cells reacted similarly, consistent with the idea that ovarian cancer begins in the fallopian tubes. "This is also the first in vitro (laboratory) study to show a direct biological effect of powder on both ovarian cancer cells and normal cells from the fallopian tubes," he said.

Approximately 220 thousand women worldwide are diagnosed with ovarian cancer each year. So far, most evidence linking women's talcum powder use to an increased ovarian cancer risk comes from 2 case-control studies conducted in 2016 using questionnaires with women who had ovarian cancer.

For example, the African American Cancer Epidemiology Study compared 584 African-American women with ovarian cancer with 745 healthy women, and reported that those who regularly used powder in the genital area were 44% more likely to be diagnosed with ovarian cancer.

A 2017 meta-analysisexamined data from 24 case-control studies and 3 cohort studies. It ultimately could not demonstrate a clear association between genital talcum powder use and ovarian cancer, and reported that the available scientific evidence on increased risk was inconsistent. Dr. Paul Boffetta, professor of oncological sciences and public health at the Tisch Cancer Institute in New York, said: "Our results showed that the evidence is somewhat uncertain and does not clearly point one way or the other. Some elements suggest there may be an association. On the other hand, some elements suggest that other factors may account for the association." he said.

Dr. Boffetta said that the Wayne State University laboratory results cannot be generalized directly to humans, and that it is difficult to know whether cells exposed to powder in a laboratory would respond the same way in a woman's body. "Experimenting with cells in an artificial environment is important, but we do not know whether the same thing happens in vivo in a real woman's ovary. These data are certainly interesting, but I would like to see more prospective studies. That is what is missing from our collective understanding," he said. Dr. Saed's next project involves injecting talcum powder directly into the reproductive systems of mice.

Dr. Saed said, "I hope these future studies confirm our findings and provide the public with important information to stop using talcum powder." .

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