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“A sprinkle a day keeps the odor away,” according to the old ads for Johnson & Johnson baby powder and Shower to Shower.  For millions of people, sprinkling baby powder on their bodies and underclothing was a daily routine.

According to a report in Epidemiology, women who routinely applied talcum powder to their genitals, underwear, sanitary napkins or tampons had a 33 percent higher risk of ovarian cancer.  Researchers at the Obstetrics and Gynecology Epidemiology Center at Brigham and Women’s Hospital in Boston did a retrospective study of 2,041 women with ovarian cancer and 2,100 similar premenopausal women and postmenopausal women who used hormone therapy without ovarian cancer, and focused on their talcum powder use.  Lead author of the study, Dr. Daniel W. Cramer, first reported the link between talc and ovarian cancer in 1982.

Talc is a moisture-absorbing mineral made of magnesium, silicon and oxygen.  In 2006, the World Health Organization classified genital talc as a possible carcinogen.  The International Agency for Research on Cancer lists talc-based body powder  as associated with ovarian cancer when applied between the legs, observing a “modest but unusually consistent excess in risk” in many case-control studies.  A 2013 study led by Harvard University of 8,525 ovarian cancer cases and 9,859 controls concluded that genital talc powder use is associated with a small-to-moderate increase in risk of various sub-types of ovarian cancer. It found that “genital powder use was associated with a similar increased risk of borderline and invasive ovarian cancer overall”. They also noted that, as there are few ovarian cancer risks women can avoid, “avoidance of genital powders may be a possible strategy to reduce ovarian cancer incidence”. This would seem a wise precautionary policy.  About 20 epidemiological studies have found increased rates of ovarian cancer risk for women using talc for genital hygiene purposes. The U.S. Centers for Disease Control does not list talc as a risk factor for ovarian cancer.

Reuters Health cites Dr. Nicolas Wentzensen, head of the clinical epidemiology unit for the National Cancer Institute, as saying that the new Brigham and Women’s study strengthens the evidence linking genital talc to the deadly reproductive cancer. He was not involved with the current study.

Still, Wentzensen isn’t fully convinced of the link because even this new study was not of the most rigorous possible design. Prospective cohort studies would be particularly strong, he noted, because they would assess exposure at the start of an investigation and follow participants over time to see if they develop the disease.  According to Wentzensen:

The recent paper in Epidemiology has provided additional support for an association between talc use and ovarian cancer from a case-control study,” he wrote.

Scientific consensus emerges over time, especially in cases like this, where the results have been somewhat inconsistent,” he said. “While this recent analysis provides additional evidence supporting an association of talc and ovarian cancer, it will be important to test the methods used in this analysis in other data to see if the findings are confirmed.

A St. Louis jury last week ordered Johnson and Johnson to pay $72 million in damages to the family of Jacqueline Fox. After using the company’s Baby Powder and Shower to Shower for more than 35 years, Fox died from ovarian cancer last year at age 62.

Johnson and Johnson maintains that scientific evidence shows that talc – long marketed for babies’ bottoms – is safe. “With over 100 years of use, few ingredients have the same demonstrated performance, mildness and safety profile as cosmetic talc,” a company statement says.  Time and more prospective studies will tell.

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