The Association Between Per- and Polyfluoroalkyl Substances (PFASs) and Brain, Esophageal, Melanomatous Skin, Prostate, and Lung Cancer Using the 2003-2018 US National Health and Nutrition Examination Survey (NHANES) Datasets

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Feb 1

PMID 38298650

Authors

Jinyoung Moon

Yongseok Mun

Affiliations

Soon will be listed here.

Abstract

Introduction: The purpose of this study was to use the US National Health and Nutrition Examination Survey (NHANES) datasets to examine potential relationships between four per- and polyfluoroalkyl substance (PFAS) exposures and each type of cancer, specifically perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA).

Methods: A logistic regression analysis was performed. A directed acyclic graph was plotted to adjust for the potential confounders.

Results: The odds ratio (OR) of brain cancer for a one-unit increase in ln (PFHxS) was 8.16 (95 % confidence interval [CI] 2.98-68.89). The OR of esophageal cancer for one unit increase of ln (PFOA) and ln (PFOS) was 5.10 (95 % CI 1.18-17.34) and 3.97 (95 % CI 1.24-11.42), respectively. The OR of melanoma for one unit increase of ln (PFOA) and ln (PFHxS) was 1.65 (95 % CI 1.07-2.58) and 1.55 (95 % CI 1.07-2.25), respectively. The OR of prostate cancer for one unit increase of ln (PFOS) and ln (PFNA) was 1.21 (95 % CI 1.00-1.48) and 1.27 (95 % CI 1.00-1.62), respectively. The OR of lung cancer for one unit increase of ln (PFOS) and ln (PFNA) was 2.62 (95 % CI 1.24-5.83) and 2.38 (95 % CI 1.00-5.52), respectively.

Discussion: Considering that brain, esophageal, and melanomatous skin cancers have not been targets of epidemiologic studies regarding PFAS exposure, future studies could target these cancers as outcomes of interest.

Citing Articles

Construction of the cancer patients' database based on the US National Health and Nutrition Examination Survey (NHANES) datasets for cancer epidemiology research.

Moon J, Mun Y BMC Med Res Methodol. 2025; 25(1):17.

PMID: 39856567 PMC: 11758729. DOI: 10.1186/s12874-025-02478-5.

Associations between per-and polyfluoroalkyl substances (PFAS) and county-level cancer incidence between 2016 and 2021 and incident cancer burden attributable to PFAS in drinking water in the United States.

Li S, Oliva P, Zhang L, Goodrich J, McConnell R, Conti D J Expo Sci Environ Epidemiol. 2025; .

PMID: 39789195 DOI: 10.1038/s41370-024-00742-2.

Perfluoroalkyl and polyfluoroalkyl substances and Cancer risk: results from a dose-response Meta-analysis.

Yang J, Zhang K, Shi J, Li Z, Dai H, Yang W J Environ Health Sci Eng. 2024; 22(2):455-469.

PMID: 39464822 PMC: 11499464. DOI: 10.1007/s40201-024-00899-w.

A toxicogenomics-based identification of potential mechanisms and signaling pathways involved in PFCs-induced cancer in human.

Dehghani Z, Ranjbar S, Shahabinezhad F, Sabouri P, Mohammadi Bardbori A Toxicol Res (Camb). 2024; 13(5):tfae151.

PMID: 39323479 PMC: 11420517. DOI: 10.1093/toxres/tfae151.

Per- and poly-fluoroalkyl substances (PFAS) effects on lung health: a perspective on the current literature and future recommendations.

Solan M, Park J Front Toxicol. 2024; 6:1423449.

PMID: 39092081 PMC: 11291370. DOI: 10.3389/ftox.2024.1423449.

References

Tsai M, Chang S, Kuo W, Kuo C, Li S, Wang M . A case-control study of perfluoroalkyl substances and the risk of breast cancer in Taiwanese women. Environ Int. 2020; 142:105850. DOI: 10.1016/j.envint.2020.105850. View

Tian Y, Zeng X, Bloom M, Lin S, Wang S, Yim S . Isomers of perfluoroalkyl substances and overweight status among Chinese by sex status: Isomers of C8 Health Project in China. Environ Int. 2019; 124:130-138. DOI: 10.1016/j.envint.2019.01.006. View

Park S, Peng Q, Ding N, Mukherjee B, Harlow S . Determinants of per- and polyfluoroalkyl substances (PFAS) in midlife women: Evidence of racial/ethnic and geographic differences in PFAS exposure. Environ Res. 2019; 175:186-199. PMC: 6579633. DOI: 10.1016/j.envres.2019.05.028. View

Levey A, Coresh J, Greene T, Stevens L, Zhang Y, Hendriksen S . Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145(4):247-54. DOI: 10.7326/0003-4819-145-4-200608150-00004. View

Steenland K, Winquist A . PFAS and cancer, a scoping review of the epidemiologic evidence. Environ Res. 2021; 194:110690. PMC: 7946751. DOI: 10.1016/j.envres.2020.110690. View

Carlson L, Angrish M, Shirke A, Radke E, Schulz B, Kraft A . Systematic Evidence Map for Over One Hundred and Fifty Per- and Polyfluoroalkyl Substances (PFAS). Environ Health Perspect. 2022; 130(5):56001. PMC: 9113544. DOI: 10.1289/EHP10343. View

Alexander B, Olsen G, Burris J, Mandel J, Mandel J . Mortality of employees of a perfluorooctanesulphonyl fluoride manufacturing facility. Occup Environ Med. 2003; 60(10):722-9. PMC: 1740403. DOI: 10.1136/oem.60.10.722. View

Xie M, Sun X, Wu C, Huang G, Wang P, Lin Z . Glioma is associated with exposure to legacy and alternative per- and polyfluoroalkyl substances. J Hazard Mater. 2022; 441:129819. DOI: 10.1016/j.jhazmat.2022.129819. View

Kingsley S, Eliot M, Kelsey K, Calafat A, Ehrlich S, Lanphear B . Variability and predictors of serum perfluoroalkyl substance concentrations during pregnancy and early childhood. Environ Res. 2018; 165:247-257. PMC: 6309672. DOI: 10.1016/j.envres.2018.04.033. View

10.

Vieira V, Hoffman K, Shin H, Weinberg J, Webster T, Fletcher T . Perfluorooctanoic acid exposure and cancer outcomes in a contaminated community: a geographic analysis. Environ Health Perspect. 2013; 121(3):318-23. PMC: 3621179. DOI: 10.1289/ehp.1205829. View

11.

Lundin J, Alexander B, Olsen G, Church T . Ammonium perfluorooctanoate production and occupational mortality. Epidemiology. 2009; 20(6):921-8. DOI: 10.1097/EDE.0b013e3181b5f395. View

12.

DeLuca N, Minucci J, Mullikin A, Slover R, Cohen Hubal E . Human exposure pathways to poly- and perfluoroalkyl substances (PFAS) from indoor media: A systematic review. Environ Int. 2022; 162:107149. PMC: 11577573. DOI: 10.1016/j.envint.2022.107149. View

13.

Moon J . Perfluoroalkyl substances (PFASs) exposure and kidney damage: Causal interpretation using the US 2003-2018 National Health and Nutrition Examination Survey (NHANES) datasets. Environ Pollut. 2021; 288:117707. DOI: 10.1016/j.envpol.2021.117707. View

14.

McGue M, Osler M, Christensen K . Causal Inference and Observational Research: The Utility of Twins. Perspect Psychol Sci. 2011; 5(5):546-56. PMC: 3094752. DOI: 10.1177/1745691610383511. View

15.

Messmer M, Salloway J, Shara N, Locwin B, Harvey M, Traviss N . Risk of Cancer in a Community Exposed to Per- and Poly-Fluoroalkyl Substances. Environ Health Insights. 2022; 16:11786302221076707. PMC: 8842173. DOI: 10.1177/11786302221076707. View

16.

VanderWeele T . Principles of confounder selection. Eur J Epidemiol. 2019; 34(3):211-219. PMC: 6447501. DOI: 10.1007/s10654-019-00494-6. View

17.

Tennant P, Murray E, Arnold K, Berrie L, Fox M, Gadd S . Use of directed acyclic graphs (DAGs) to identify confounders in applied health research: review and recommendations. Int J Epidemiol. 2020; 50(2):620-632. PMC: 8128477. DOI: 10.1093/ije/dyaa213. View

18.

Domingo J, Nadal M . Per- and Polyfluoroalkyl Substances (PFASs) in Food and Human Dietary Intake: A Review of the Recent Scientific Literature. J Agric Food Chem. 2017; 65(3):533-543. DOI: 10.1021/acs.jafc.6b04683. View

19.

Perez-Stable E, Benowitz N, Marin G . Is serum cotinine a better measure of cigarette smoking than self-report?. Prev Med. 1995; 24(2):171-9. DOI: 10.1006/pmed.1995.1031. View

20.

Tansel B . PFAS use in electronic products and exposure risks during handling and processing of e-waste: A review. J Environ Manage. 2022; 316:115291. DOI: 10.1016/j.jenvman.2022.115291. View