Johnson & Johnson settlement: Does talcum powder really increase ovarian cancer risk?

As Johnson & Johnson agrees to a multibillion-dollar settlement over talc lawsuits, cancer specialists and dermatologists explain the scientific evidence about ovarian cancer risk, asbestos contamination and whether regular users should be worried.

Talcum powderJohnson & Johnson has sold talc-based baby powder and other products for decades. Wikimedia Commons

Johnson & Johnson (J&J) has agreed to pay billions of dollars to settle lawsuits alleging that its talcum powder products caused ovarian cancer and other illnesses because they contained asbestos. 

The proposed settlement, among the largest of its kind in US history, comes after years of litigation, conflicting scientific evidence and repeated legal setbacks for the company.

For decades, the pharmaceutical giant sold talc-based baby powder and other products. Thousands of consumers alleged that long-term use caused ovarian cancer and mesothelioma — a rare and aggressive cancer in the thin tissue lining our internal organs — because the talc was contaminated with asbestos, a known carcinogen. The company has consistently denied that its talc products were unsafe and says the settlement is intended to end years of costly litigation and provide certainty for claimants and shareholders.

In 2020, J&J stopped selling talc-based baby powder in the US and Canada. In 2023, it discontinued talc-based baby powder globally, replacing it with a cornstarch-based formulation. 

So how safe is your talcum powder? What are its chances of getting contaminated with asbestos? What about the cancer risks? We explain, citing experts.

Based on current medical evidence, what is the scientific consensus on the link between talcum powder and ovarian cancer?

The International Agency for Research on Cancer (IARC) classifies talc, not containing asbestos, as “probably carcinogenic to humans” (what is called group 2A) for ovarian cancer, based on limited evidence in humans and sufficient evidence in animal studies. 

“There is not sufficient evidence to support that talc is a definite (or Group 1) carcinogen for ovarian cancer. Prospective cohort studies, which are less prone to recall bias than case-control studies, have generally not shown a statistically significant increase in risk for ovarian cancer,” says Dr Gauravi Mishra, Deputy Director, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Mumbai

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How does cosmetic talc differ from asbestos and under what circumstances can talc become contaminated with asbestos?

Talc and asbestos are both naturally occurring silicate minerals that may co-form within the same geological deposits, a relationship documented in geological studies since the late 19th century. “Contamination of talc with asbestos is, therefore, dependent on the mine of origin and the rigour of ore screening, and is not an inherent property of the consumer talc product itself. Mining of asbestos is banned in India. Existing tests are not sensitive enough to reliably exclude trace asbestos contamination. Hence, there is no standardised testing method currently recommended by any regulatory body,” says Dr Ashwin Sathyan, senior resident, Department of Preventive Oncology, CCE.

Should people who have used talcum powder regularly for years be concerned?

There is no cause for alarm among long-term users of talcum powder. This position is consistent across IARC and independent reviews. “Prior use should not be attributed as the cause of any current symptoms without appropriate clinical evaluation. Women with a family history of ovarian or breast cancer are advised to discuss this concern with their physician,” advises Dr Mishra.

What are the current guidelines about use of talcum powder?

No major regulatory or scientific body has issued a prohibition on talcum powder use on any body part, including the genital area. “Use of talc on open wounds or sensitive skin is not recommended, as it may lead to irritation or mineral toxicity. Regulatory policy in India is still under development and scrutiny,” says Dr Mishra. 

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The Central Drugs Standard Control Organisation (CDSCO) ordered a manufacturing halt for one major brand in 2018 pending asbestos-free certification, and the Maharashtra Food and Drug Administration (FDA) cancelled a manufacturing licence in 2022 on grounds of pH specification and not cancer-associated risks.

“Talc is not a reason for panic but it is also not an indispensable personal care product. Given the remaining uncertainty, the prudent approach is to choose a traceable, talc-free product where a powder is genuinely needed,” says Dr Usha Khemani, associate professor of dermatology, JJ Hospital, Mumbai.

However, there are caveats. According to Dr Pralhad Rathod, professor and HOD, dermatology at JJ Hospital, Mumbai: “Body powder should be avoided altogether on babies, especially near the nose and the mouth; in individuals with asthma or chronic respiratory diseases; on raw, broken, inflamed, or infected skin; when there is an undiagnosed genital rash; where the powder repeatedly cakes with sweat and increases friction; in poorly ventilated areas.”

Are cornstarch-based powders a safer alternative?

Cornstarch-based powders are a reasonable substitute, being plant-derived and free of any asbestos-contamination pathway. “They are not linked in literature to ovarian cancer risk. Body powders of either type are best avoided on broken or irritated skin, on post-surgical or post-partum wounds, and in infants, where inhalation risk is highest,” says Dr Mishra.

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Are India-made talcs safe?

Available India-specific data is limited and in its early stages. “Tremolite asbestos was found in seven of 13 commercially available Indian talc products tested, and an earlier Indian Institute of Toxicology Research (IITR), Lucknow report similarly identified asbestos fibres in five Indian brands,” says Dr Sathyan.

Under India’s Cosmetics Rules, 2020, finished skin powders must conform to the applicable Bureau of Indian Standards specifications: IS 3959 for skin powders and IS 5339 for infant skin powders, respectively. A peer-reviewed Indian public health review has also called for stronger asbestos testing and regulatory transparency in the talc manufacturers. “Consumers should look for a licensed manufacturer, complete labelling, and traceable batch details, while regulators should ensure periodic market sampling and sensitive asbestos testing,” says Dr Rathod.

Besides, the IARC hazard classification is not a calculation of the risk from the occasional personal use. “This means that under certain exposure circumstances, the substance is capable of causing cancer; it does not mean that every user — or even most users — will develop cancer,” says Dr Rathod.

Rinku Ghosh is the Health Section Lead at The Indian Express, where she oversees the publication’s comprehensive health, wellness, and medical science vertical. With years of experience in high-impact journalism, Rinku specializes in translating complex medical research into actionable insights for the public. Her reporting spans a wide spectrum—from deep-dives into childhood obesity and the effects of urban pollution to the frontiers of medical technology, such as the use of AI and nanobots in cancer treatment. Authoritativeness: As a veteran editor at one of India’s most trusted news organizations, Rinku has interviewed world-renowned experts, including cardiologists from the Mayo Clinic, oncologists from AIIMS, and researchers from the Indian Institute of Science (IISc). Her column often serves as a primary source for "Explained" features, where she breaks down global health trends, vaccine safety, and public health policy. Her work is recognized for bridging the gap between clinical data and the lived experiences of patients. Trustworthiness: Rinku’s editorial approach is rooted in the "Journalism of Courage" philosophy, prioritizing evidence-based science over healthcare myths. In an era of medical misinformation, she ensures that every piece of advice—whether regarding chronic disease management or nutritional supplements—is backed by peer-reviewed studies and verified by leading medical practitioners. ... Read More

 

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