New research published this week lends credence to more than 50,000 lawsuits against the American multinational company Johnson & Johnson alleging that its baby powder causes ovarian cancer.
The analysis, which was published Wednesday in The Journal of Clinical Oncology, found that applying talcum powder to the genitals was associated with ovarian cancer and that this association was greater for those who used it frequently and for extended periods of time.
The researchers are part of the National Institutes of Health (NIH) and their findings are based on data from the Sister Study, which included more than 50,000 women in the United States from 2003 to 2009. The participants joined when they were between 35 and 74 years old and each had a sister diagnosed with breast cancer, which could put them at higher risk for breast or ovarian cancer.
Lawsuits linked to J&J baby powder date back to 1999, when a woman alleged that after a lifetime of using it she suffered from mesothelioma, a rare cancer caused by exposure to asbestos, a known carcinogen. In 2009, another woman sued the company alleging that its talc-based products had caused her ovarian cancer. Since then, thousands of other people have filed lawsuits over cases of ovarian cancer or mesothelioma that they say were caused by asbestos in J&J's baby powder.
J&J has defended the safety of its talc products and denies that they contain asbestos. It has also argued that studies have not shown a convincing link between ovarian cancer and such products.
The new investigation could detract from that argument as legal battles continue. Most of the complaints against J&J have been consolidated into a single federal case in New Jersey, which is scheduled for trial in December.
“This study is very timely. We believe it fully affirms and confirms the position of experts and plaintiffs,” said Leigh O'Dell, principal at the Beasley Allen law firm. O'Dell is co-chair of the plaintiffs' coordinating committee, a group of attorneys appointed to act on behalf of those with cases pending against J&J.
However, Erik Haas, J&J's vice president of global litigation, said the new analysis does not establish causality or imply a specific cancer-inducing agent. “The study does not change the overwhelming evidence showing that talc does not cause ovarian cancer,” he said.
Earlier this month, J&J proposed a $6.48 billion payment to resolve the lawsuits, but the settlement would require moving the cases through bankruptcy court and requiring 75% of plaintiffs to vote in favor.
J&J has tried and failed twice in its attempts to resolve such claims in bankruptcy court. In 2021, the company created a subsidiary that could take responsibility for legal claims related to talc, a legal maneuver known as Texas two-step. But so far, courts have dismissed their requests on the grounds that the subsidiary is not in financial difficulty.
O'Dell said her team “would like to see these women offered a reasonable and fair resolution outside of bankruptcy.”
Possible harm from talc-based products
The recent research asked women how often they used talcum powder on their genitals when they were between 10 and 13 years old, and in the year before they enrolled in the study. NIH researchers followed them with surveys in 2017 to 2019 that asked about lifetime use.
Based on the responses, the researchers estimated that 56% of them used talcum powder on their genitals at some point. These women tended to be black, less educated, and living in the South, compared to those who did not use it.
The analysis cannot prove that talc causes ovarian cancer, nor does it identify a brand or chemical responsible for such an association. Dale Sandler, one of the study's authors and chief of the epidemiology branch at the National Institute of Environmental Health Sciences, said there is probably no way to prove causality in studies in people.
“It is not possible to do a clinical trial and randomly assign people to powder with talcum powder and powder without talcum powder. So we will have to turn to other types of research,” she said.
As minimum, findings should prompt women to rethink using talc-based productssaid Katie O'Brien, lead author of the analysis and an epidemiologist at the National Institute of Environmental Health Sciences.
“We don't know of any medically necessary reason why someone should use talcum powder,” he said.
Current J&J baby powder formulas use cornstarch, not talc. The company withdrew talc-containing versions from the North American market in 2020, citing decreased demand and “misinformation about product safety,” and stopped marketing it internationally last year.
Talc and asbestos are found in close proximity in nature, so some raw talc collected through mining may be contaminated with asbestos, according to the Food and Drug Administration (FDA).
A Reuters investigation in 2018 suggested that J&J knew since the 1970s that some of its baby powders were contaminated with small amounts of asbestos. But the company denies that asbestos has been present in its products.
O'Brien said asbestos might not be the only reason for the association between talc and cancer. Some talcum powder products may also contain phthalates, chemicals that disrupt the body's hormones and have been linked to ovarian cancer. Additionally, talcum powder itself can be abrasive, he added, and cause inflammation in the areas where it is applied. Inflammation is independently associated with cancer.
J&J began selling talcum-based baby powder in 1894.
Although many women have used it to keep their genitals dry, there is no need to resort to powders to remove moisture from that area, according to Alexandra Scranton, director of science and research at Women's Voices for the Earth, a nonprofit organization whose The objective is to eliminate chemical substances that negatively affect women's health.
“Moisture in this part of the body is very healthy,” Scranton said. “This part of the body is covered with mucous membranes. “It’s supposed to be moist.”