Johnson & Johnson Ordered To Pay $72 Million In Ovarian Cancer Case

Update: This article has been updated to include expert comments.

This post was originally published on February 24, 2016.

A Missouri state jury has ruled that behemoth personal-care products company Johnson & Johnson must pay $72 million to the family of a woman who died of ovarian cancer after using the company's baby powder for decades, Reuters reported Wednesday.

Jacqueline Fox
, who died in October at the age of 62, was the first of more than 60 plaintiffs in the lawsuit to have her case come to trial. Fox's lawyers told Reuters that she used Johnson & Johnson's baby powder for more than 35 years for feminine hygiene before being diagnosed with ovarian cancer. The case alleges that the company knew that its talcum powder raised the risk for ovarian cancer and did not warn consumers. According to the ruling, the company must pay Fox's family $10 million in actual damages and $62 million in punitive damages. Johnson & Johnson is expected to appeal the ruling.

"We have no higher responsibility than the health and safety of consumers, and we are disappointed with the outcome of the trial," Carol Goodrich, a Johnson & Johnson spokeswoman said in a prepared statement provided to multiple outlets. "We sympathize with the plaintiff's family but firmly believe the safety of cosmetic talc is supported by decades of scientific evidence."

Ovarian cancer isn't the most common cancer in women but it is among the more deadly cancers, because there is no official screening test for it, and the symptoms, which include bloating and abdominal pain, are vague and can mimic other problems. So it's often caught after it has progressed past the earliest stages, when treatment is most effective. According to the latest numbers available from the Centers for Disease Control and Prevention (CDC), ovarian cancer struck roughly 20,000 women in 2012, and 14,404 women died from it.

There are about 1,200 cases reportedly pending involving talcum powder's link to ovarian cancer. But whether there actually is a link remains murky. Per the American Cancer Society, there have been multiple studies on whether talcum powder, which is made of the naturally occurring mineral talc, causes ovarian cancer, but the findings are mixed. Some have found a slightly increased risk, while others have found no increase.

The concern centers around using the powder to fight down-there odor. The International Agency for Research on Cancer (IARC) has classified perineal use of talc (a.k.a. putting it on your genitals) as "possibly carcinogenic" based on the research available. This means that there is limited evidence that it caused cancer in humans and "less than sufficient evidence" that it causes cancer in lab animals.

As late as the 1970s, many talc products contained asbestos, which is why talc has also been associated in the past with other serious health issues like mesothelioma, explains Daniel Cramer, MD, a professor of epidemiology at Harvard T.H. Chan School of Public Health in Boston. But thankfully, that's not a concern any longer, since manufacturers now know to test their products to ensure they are pure.

Still, in this case, "the association with ovarian cancer is not due to asbestos. It's due to the talc itself," Dr. Cramer says, citing a recent large-scale study he published in the journal Epidemiology. For that study, Dr. Cramer and a team of researchers examined more than 2,000 cases of women with ovarian cancer (matched with around 2,000 controls), looking at the women's use of talc, and how long they used it. Overall they saw a 33% increase in risk for ovarian cancer among the women who used it on sanitary pads, in their underwear or on their genitals, versus those who did not. They also found that the women who used it tended to be older and more likely to be asthma-sufferers.

Not everyone is convinced the link is that clear: “Despite an observed association, several decades of medical research do not support the hypothesis that use of talcum powder causes ovarian cancer," says Hal C. Lawrence, III, MD, EVP of the American Congress of Obstetricians and Gynecologists. "Because of concerns regarding potential discomfort or pain, obstetrician-gynecologists do not recommend use of vaginal treatments such as douche, vaginal sprays or talcum powder. However, there is no medical consensus that talcum powder causes cancer, including ovarian cancer.”

It's also important to remember that cancer isn't usually caused by one specific thing: "The majority of women who develop ovarian [cancer] do so from other risk factors, including age, genetic predisposition, reproductive issues, and whether they were on birth control," Eva Chalas, MD, told USAToday.

The bottom line: Any potential risks of talcum powder seem to be just associated with using it in the genital region, Dr. Cramer says. And as Dr. Lawrence points out, there are other reasons to not use products that way.

When we asked whether using baby powder on other areas, like as a dry shampoo, could be risky, he said using it "sporadically" elsewhere is probably not harmful or particularly risky, but added that cornstarch-based products seem to work just as well.

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