Some women apply talcum powder directly in their genital area to absorb moisture, reduce friction, prevent chafing, protect against rashes, and keep the skin dry and clean. However, applying talcum powder is now causing concern because some talcum powder contains minerals that are thought to cause carcinogenic effects.

Does Talcum Powder Cause Cancer?
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In 2018, a case in court in the United States sued a company that manufactures medical equipment, pharmaceuticals, and consumer goods. In that case, the lawsuit stated that the powder product from the company contained asbestos, which is carcinogenic, causing ovarian cancer in one of its consumers. The case was won by the plaintiff and caused a huge loss to the company.


What substance contains talcum powder that causes cancer?

Talcum powder is made from talc, a mineral made up mainly of magnesium, silicon, and oxygen. However, some talcum powders contain asbestos. Asbestos is a carcinogenic substance that causes mesothelioma. Some theories state that asbestos in talcum powder entries into the vagina, can go to the uterus and then through the fallopian tubes, thus affecting the ovaries and causing cancer.


Scientific Evidence Related to Talcum Powder and Ovarian Cancer Risk

In 2016, Cramer et al. conducted a case-control study to find out more about the link between applying talcum powder and ovarian cancer. They analyzed 2041 cases of ovarian cancer and 2100 controls. The analysis showed that talcum powder could increase the risk of ovarian cancer as much as 1.3 times. 

Also, Cramer et al. reported that women who used talcum powder tended to be older, have heavier bodyweight, suffer from asthma, and consume analgesics regularly, but none of these factors was confounding. Applying talcum powder is reported to be more linked with endometrioid invasive serous tumors and mucinous serous borderline tumors.

In 2018, a systematic review and meta-analysis were conducted on 24 case-control studies and three cohort studies to determine the association between applying talcum powder and ovarian cancer risk. This study found an increased risk of ovarian cancer by 1.22 times in patients who apply talcum powder on genitals. However, the heterogeneity of the data causes the causal relationship between the two cannot be concluded.

A recent study related to the association of talcum powder and ovarian cancer was published in JAMA in early 2020. Methodologically and quantity of samples, the evidence's strength is better than the two studies described above. This study analyzed samples from 4 large cohorts in the United States. The total sample analyzed was 252,745 people. 38% of subjects conducted self-reporting regarding the use of talcum powder in the genital area. Of these, 10% reported long-term use, and 22% reported frequent use. In a median of 11.2 years of monitoring, 2168 women were diagnosed with ovarian cancer. The incidence of ovarian cancer found 61 cases / 100,000 person-years in patients using talcum powder, and 55 cases / 100,000 person-years in controls.

This study found an increased risk of 1.09 times in patients using talcum powder often compared to controls and a 1.01 times increase in patients on long-term users. Therefore, the researchers concluded no significant relationship between talcum powder use and ovarian cancer risk.

The CDC does not list talcum powder as a risk factor for ovarian cancer. Meanwhile, IARC (International Agency for Research on Cancer), which is part of WHO, states that applying talcum powder on the genital area may be carcinogenic in humans.

Clinical Implications
Meanwhile, applying talcum powder on the genital has not been proven safe. However, at the same time, a recent study with good evidence strength showed no significant increase in risk associated with ovarian cancer in the use of talcum powder Caution is needed in applying talcum powder on the genital.

If the patient has a tendency to sweat in the genital area, several other things can be tried to replace the use of talcum powder, for example, wearing cotton underwear and often changing underwear and avoiding wearing tight pants.

Conclusion
Previous observational studies have shown that applying talcum powder in the genital area increases the risk of ovarian cancer. This is thought to be due to mineral content, especially asbestos, which is in talcum powder and is carcinogenic. However, a cohort with a large sample size shows the opposite. Further studies are still needed before more definitive conclusions can be drawn.