Most notably, a European Food Safety Authority safety assessment published in May 2021 pointed to genotoxicity concerns, as suggested by previous research. Genotoxicity is the ability of chemicals to damage genetic information such as DNA, which may lead to cancer.

In a study published in the journal Food and Chemical Toxicology in 2016, researchers investigated whether titanium dioxide exposure led to an increase in colorectal tumor creation in mice by using a colitis associated cancer model. By measuring tumor progression markers, the researchers found that mice given titanium dioxide experienced enhanced tumor formation in the distal colon.  There was also a decrease of cells that act as a protective barrier in the colon. The researchers wrote: “These results suggest that E171 could worsen pre-existent intestinal diseases.”