A Drop in Ovarian Cancer Deaths Could be Due to Birth Control Pills

WEDNESDAY, Sept. 7, 2016 (HealthDay News) — Ovarian cancer deaths are down dramatically in many parts of the world, and researchers believe the use of birth control pills may be a main reason why.

The analysis of World Health Organization data found that the ovarian cancer death rate fell 16 percent in the United States and almost 8 percent in Canada between 2002 and 2012.

In the European Union, the ovarian cancer death rate fell 10 percent, though some countries saw far more significant drops. The United Kingdom’s ovarian cancer death rate went down by 22 percent. Denmark and Sweden each saw a drop of 24 percent in their death rate from ovarian cancer, the researchers said.

Ovarian cancer deaths also decreased about 12 percent in both Australia and New Zealand. In Japan, the ovarian cancer death rate declined 2 percent, the study found. Japan has low rates of birth control use, the researchers said.

Ovarian cancer death rates are expected to continue to decline 15 percent in the United States, and 10 percent in the European Union and Japan by 2020.

In Latin America, the results were mixed. Argentina, Chile and Uruguay had decreases in ovarian cancer death rates between 2002 and 2012. But, Brazil, Colombia, Cuba, Mexico and Venezuela all had increases, according to the study.

The study was published Sept. 6 in the journal Annals of Oncology.

The study wasn’t designed to prove cause-and-effect. However, a big reason for the decline in ovarian cancer death rates in some parts of the world is likely the use of birth control pills and the long-term protection against ovarian cancer they provide, study leader Dr. Carlo La Vecchia, a professor in the Faculty of Medicine at the University of Milan, Italy, and colleagues, suggested.

Other factors may include reduced use of hormone replacement therapy to manage menopausal symptoms and better diagnosis and treatment of ovarian cancer, the researchers said.

“As our understanding of preventable causes of this major cancer progresses, early detection strategies are being developed and novel therapeutic options become available, we enhance our ability to reduce ovarian cancer mortality,” Dr. Paolo Boffetta, the journal’s associate editor, wrote in an accompanying editorial. Boffetta is also director of the Institute of Translational Epidemiology at the Icahn School of Medicine at Mount Sinai in New York City.

More information

The American Cancer Society has more on ovarian cancer.

Third Lawsuit Links Ovarian Cancer to Johnson & Johnson Baby Powder

A Missouri jury has awarded more than $70 million to a woman who alleged in a lawsuit that her cancer was caused by Johnson & Johnson baby powder.

Deborah Giannecchini of Modesto, Calif., was diagnosed with advanced in 2012. In her suit against Johnson & Johnson, she claimed that her diagnosis was the result of years of using the company’s talc-based powder, the Associated Press reports.

“We are pleased the jury did the right thing,” Jim Onder, an attorney for Giannecchini, told the AP. “They once again reaffirmed the need for Johnson & Johnson to warn the public of the ovarian cancer risk associated with the product.”

This isn’t the first time the company has been involved in a lawsuit over its popular baby powder. In February, a Missouri jury ruled that Johnson & Johnson must pay $72 million to the family of the late Jacqueline Fox, who died of ovarian cancer in 2015. And in May, another Missouri jury ruled the company should pay $55 million to a South Dakota woman who survived. But two similar suits in New Jersey were thrown out after a judge deemed there was insufficient evidence linking the mineral talc to ovarian cancer, according to the AP.

RELATED: The Ovarian Cancer Symptoms You Should Never Ignore

So is using baby powder actually a cancer risk? “The data is wishy-washy,” Mary Jane Minkin, MD, clinical professor of Obstetrics, Gynecology, and Reproductive Services at Yale School of Medicine, previously explained to Health. While some studies haven’t found any connection between talc powders and ovarian cancers, others suggest a small increase in risk. “And there are lots of different variables in these studies for researchers to consider,” she said. (For more on what’s currently known about the possible link, check out “Can Using Baby Powder Down There Really Cause Cancer?”)

Johnson & Johnson maintains there is no danger in using its product. The company sent a statement to the AP about the most recent lawsuit: “We deeply sympathize with the women and families impacted by ovarian cancer,” spokeswoman Carol Goodrich said. “We will appeal today’s verdict because we are guided by the science, which supports the safety of Johnson’s Baby Powder.”

The Ovarian Cancer Symptoms You Need to Know, Even If You’re Young

In a candid essay for Lenny Letter this week, Cobie Smulders opened up about the ovarian cancer diagnosis she received when she was only 25 years old: “Just when your ovaries should be brimming with youthful follicles, cancerous cells overtook mine,” she writes, “threatening to end my fertility and potentially my life.”

Now 34 and a mother of two, the star is hoping to raise awareness about the deadliest form of female reproductive cancer, estimated to affect some 22,000 American women in 2016 alone.

It’s rare for the disease to strike a woman in her 20s, but not impossible. There are several forms of , including hereditary types linked to the BRCA gene mutation. The hereditary types are more likely to occur in younger women, says Nimesh Nagarsheth, MD, associate professor of obstetrics, gynecology, and reproductive science at Icahn School of Medicine at Mount Sinai. “The epithelial ovarian cancers are the more commons ones that we hear and talk about, which generally occur later in life.” (Smulders hasn’t said what type she had.)

However, Dr. Nagarsheth adds, there are no rules about what types of ovarian cancer will strike when, or how a patient’s age will affect her outcome: “There’s so much more to it than just age,” he says. “There are too many variables—like the type of cancer and its aggressiveness—to make generalized statements about ovarian cancer in younger populations.”

It’s safe to say that most 20-somethings don’t have the disease on their mind. As Smulders writes in the beginning of her moving essay, “I was 25. Life was pretty simple.” But when her body began to feel “off,” she didn’t ignore her symptoms: “My energy was low, I was just so tired all the time, and I felt a constant pressure on my abdomen that I could not explain. I listened to my body and immediately went to my gynecologist.”

RELATED: The Ovarian Cancer Symptoms You Should Never Ignore

The fact that Smulders saw her doctor then may have saved her life. When the disease is caught early, 94% of women will survive longer than five years. But in most cases, ovarian cancer isn’t diagnosed until stage 3 or 4.

One reason it goes undetected is that there’s room in the abdomen and pelvis for organs to shift as the cancer grows, says Dr. Nagarsheth. “You don’t really notice it until you have areas that can no longer move due to the fact that there’s a large mass or tumor within.”

Once symptoms do present, patients may experience abdominal pain or discomfort (as Smulders described), as well as bloating, constipation, and early satiety (or a “full” feeling after eating a small amount of food), Dr. Nagarsheth says.

“Every person is different and every situation is different,” he adds. “If there are any signs or symptoms you’re experiencing, the best thing to do is talk to your gynecologist or primary care physician. Do not be afraid to get your symptoms checked.”  

Smulders now has a clean bill of health, after enduring multiple surgeries, and trying a long list of lifestyle changes and alternative therapies. She urges other women faced with scary diagnoses to take their health into their own hands: “If you are going through something like this, I urge you to look at all your options. To ask questions. To learn as much as you can about your diagnosis. To breathe. To ask for help. To cry and to fight.”

RELATED: Knowing These Ovarian Cancer Facts Could Save Your Life

If you want to reduce your risk of developing ovarian cancer, you might consider the pill, says Dr. Nagarsheth: “Taking birth control pills for up to two to three years can reduce your risk by up to 40 to 50%.”  Pregnancy is also protective against the disease.

Women who are at particularly high risk may consider prophylactic procedures, he adds. “BRCA mutation patients or hereditary risk patients have more options. They may choose to take out their [fallopian] tubes and ovaries at an early age because they have a known, definitive, genetic risk factor.”

Can Using Baby Powder Down There Really Cause Cancer?

A jury has ordered Johnson & Johnson to pay $417 million in damages to a 63-year-old woman in Los Angeles who developed ovarian cancer after using the company’s talc-based baby powder for decades.

Like many women who use baby powder to freshen up or reduce chafing between their thighs, on their genitals, or in their underwear, 63-year-old Eva Echeverria was unaware for many years of the potential link between ovarian cancer and talc, an ingredient in some types of baby powder.

This isn’t the first time the company has been involved in a lawsuit over its popular powder—and it will likely face hundreds more cases in the future, according to Reuters. In May, a Missouri jury awarded $110 million to a Virginia woman who alleged that her cancer was caused by baby powder, and last October, a Missouri woman was awarded more than $70 million.

Earlier in 2016, Johnson & Johnson was also ordered to pay $72 million to the family of a woman who died in 2015, and $55 million to a South Dakota woman who survived. Two similar suits in New Jersey and one in Saint Louis have been dismissed after a judge deemed there was insufficient evidence linking talc to ovarian cancer.

Johnson & Johnson said in a statement that the company will appeal this latest verdict, and cites a National Cancer Institute report from April that found the weight of evidence “does not support an association between perineal talc exposure and an increased risk of ovarian cancer.” (However, the New York Times reports, the report takes a different tone in another section, noting that “it is not clear” whether talc is a risk factor for cancer.)

All of this may leave you wondering, “So … can using baby powder cause ?” Well, here’s the thing: We wish we could give you a resounding, emphatic “no way.” But the answer to this question is murky. Here’s everything we know so far.

RELATED: Knowing These Ovarian Cancer Facts Could Save Your Life

So what is talc, exactly?

Talc is a naturally occurring mineral found in baby powders as well as other cosmetic and personal care products, and it’s good at absorbing moisture, cutting down on friction, and preventing rashes. For many years, parents used it to diaper babies, until doctors began discouraging it for health reasons. As for adults, many still use it around their genitals or rectum to prevent chafing or sweating, says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive services at Yale School of Medicine.

As the American Cancer Society points out on its website, talc in its natural form may contain asbestos, a known carcinogen.

The FDA does not allow talc-based products to contain any asbestos. But the trouble is, cosmetics don’t have to be reviewed or approved by the FDA before they land on store shelves, so there’s no guarantee that they haven’t been contaminated.

In light of this concern, the FDA visited several retail outlets in the Washington, D.C. metro area and bought and tested a variety of cosmetic products containing talc across a wide range of prices for a study that ran from 2009 to 2010. They found no traces of asbestos in any of the products.

But of course, that doesn’t prove that all talc-based products are asbestos-free.

RELATED: 10 Products You Think Are Healthy, But Aren’t

Can “asbestos-free” talc cause ovarian cancer?

As of now, it’s unclear. The FDA says that literature dating back to the 1960s has suggested a possible association between talc powders and ovarian cancer.

But “the data is wishy-washy,” says Dr. Minkin. “Some studies haven’t found a connection, and other ones have only shown a small increase in the hazard ratio [or risk]. And there are lots of different variables in these studies for researchers consider.”

For example, one 2013 study analyzed nearly 20,000 people and found that those who used any type of powder down there were 20% to 30% more likely to have ovarian cancer than those who didn’t use any powder. The findings led the researchers to suggest that “avoidance of genital powders may be a possible strategy to reduce ovarian cancer incidence.”

However, the researchers pointed out a few of the study’s limitations: Participants might have overestimated how often they used these products, and not all powders contain talc—some contain cornstarch instead (more on that later).

Then, a 2014 study published in the Journal of the National Cancer Institute looked at data from about 60,000 women and found no link between powder use and ovarian cancer risk.

Back in 2010, the International Agency for Research on Cancer (part of the World Health Organization) concluded that there is “limited evidence in humans” that using talc-based body power on the genital areas is “carcinogenic,” and stated that using it down there is “possibly carcinogenic in humans.”

Robyn Andersen, PhD, an ovarian cancer researcher at Fred Hutchinson Cancer Research Center, says that when she works with women with ovarian cancer, she asks them about their use of talcum powder. “We know it’s a possible risk factor, we just don’t know how [big] of a risk factor it is,” she says.

Andersen says that because the powder is made up of such finely-ground particles, it might be able to travel up the mucus membranes in the vaginal canal and eventually work its way into the ovaries. Once there, the powder might cause inflammation and eventually cancer.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

What you should know

On its “Facts About Talc” website, Johnson & Johnson states that its talc-based products are are asbestos-free, and cites several studies that found no overall increase in ovarian cancer risk among women who used talcum powder versus women who didn’t. It also cites that FDA study mentioned above, which found no asbestos in Johnson & Johnson’s talc-based baby powder.

That said, if all of this is enough to creep you out—understandably—you’ve got other options besides talc-based powder. Some baby powders (including some by J&J) contain cornstarch instead of talc, and there is no evidence linking cornstarch to ovarian cancer, according to the American Cancer Society.

Something else to keep in mind: when it comes to vaginal health solutions, sometimes less is more.