Per- and polyfluoroalkyl substances levels other than PFOS, PFOA, or PFHxS and liver cancer risk: a nested case-control analysis
Abstract
Abstract Epidemiologic studies of PFAS and liver cancer risk have produced conflicting results with no strong or clear associations for pre-diagnostic perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorohexanesulfonate (PFHxS). We now report analyses of nine additional PFAS in a nested case-control study within 12 prospective cohorts (853 cases, 853 matched controls) in the United States. Using multivariable-adjusted conditional logistic regression, we estimated odds ratios per 90th vs. 10th percentile increase in PFAS levels. Perfluoroheptanoic acid (PFHpA) was positively associated with liver cancer risk (OR: 1.78, 95% CI: 1.26–2.52); no associations were observed for other PFAS. Significant heterogeneity was observed by sex, cancer subtype, and time from blood collection. Associations were stronger among males (OR: 3.72, 95% CI: 2.10–6.59), for hepatocellular carcinoma (4.53, 2.59–7.94), and for those diagnosed ≤10 years after blood collection (3.17, 1.80–5.57). Given continued use of short-chain PFAS in consumer products, further research on their effects on liver health is warranted.
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Authors: Cody Z. Watling, Jessica L. Petrick, Barry I. Graubard, Hyokyoung G. Hong, Xuehong Zhang, Matthew J Barnett, Mollie E. Barnard, Yu Chen, A Heather Eliassen, J Michael Gaziano, Wen‐Yi Huang, Jae H Kang, Jill Koshiol, I-Min Lee, Erikka Loftfield, Steven C Moore, Lorelei A Mucci, Marian L Neuhouser, Christina C. Newton, Howard D Sesso, Martha Shrubsole, Rashmi Sinha, Lesley Tinker, Triplette Matthew, Caroline Y. Um, Kala Visvanathan, Jean Wactawski‐Wende, Eleanor L. Watts, Walter C Willett, Fen Wu, Wei Zheng, Peter T. Campbell, Jonathan N Hofmann, Mark P. Purdue, DINESH BARUPAL, Katherine A. McGlynn
Institutions: Brigham and Women's Hospital, Icahn School of Medicine at Mount Sinai, Johns Hopkins University, University at Buffalo, State University of New York, Vanderbilt University, Albert Einstein College of Medicine, Vanderbilt Health, Boston University, Yale University, New York University, National Cancer Institute, VA Boston Healthcare System, Division of Cancer Epidemiology and Genetics, Fred Hutch Cancer Center, Yale New Haven Health System, Cape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa, American Cancer Society