A Cross-Sectional Study of the Association Between Per- and Polyfluoroalkyl Substances and Prevalent Hormone-Dependent Cancer Diagnoses Among NHANES Study Participants, 2011-2018
Year: 2024
Type: dissertation
Study design: Observational Study
Abstract: This thesis aims to investigate the relationship between exposure to per-and polyfluoroalkyl substances (PFAS) and self-reported hormone-dependent cancer diagnoses.Previous studies reveal associations between PFAS and adverse health outcomes including altered immune response and potential carcinogenicity, as well as its role as an endocrine disrupting chemical (EDC).Exposure to EDCs is further associated with increased cancer risk, however, epidemiologic evidence is limited and inconclusive linking PFAS exposure to hormonedependent cancer development.Data were collected from four consecutive NHANES survey cycles between 2011 and 2018.PFAS biomarker assessment involved the extraction of six PFAS measured in serum concentrations.PFAS serum concentrations were categorized by quartiles for analysis.Hormone-dependent cancer outcomes included breast, ovarian, prostate, testicular, and thyroid cancers.Significant testing in proportions and geometric means were calculated with chisquare and one-way ANOVA tests, respectively.Logistic regression models were used to examine the association between each PFAS analyte and the odds of self-reported cancer diagnosis among 8,415 NHANES participants.Significant differences in PFAS serum concentrations were observed across sociodemographic groups, with higher mean concentrations in males compared to females.Concentrations of four of the six studied PFAS were detected in iv 97-99% of all participants.Previous prostate cancer among men was inversely associated with PFUA Q3 (OR: 0.42, 95% CI: 0.20, 0.91).Increased odds of combined previous hormonedependent cancers among men were associated with PFOS Q4 (OR: 1.78, 95% CI: 1.02, 3.11), whereas combined previous hormone-dependent cancers among women were inversely associated with PFOS Q4 (OR: 0.51, 95% CI: 0.29, 0.91).Reduced odds of previous breast cancer were also observed with PFOS Q4 (OR: 0.39, 95% CI: 0.19, 0.78).Previous ovarian cancer was associated with PFDeA Q4 (OR: 3.25, 95% CI: 2.08, 5.10).Both increased and decreased odds of previous thyroid cancer in women were observed among various PFAS quartiles.Overall, there was considerable variability of effect estimates between PFAS serum exposure and sex-specific cancer sites.These findings suggest a sexual dimorphic biological response to PFAS exposures.Further investigation is required to investigate sex-mediated mechanisms of these environmental exposures implicated in cancer development.
Author: Aybar, Defne Melis
Language: English
Subfield: Environmental Chemistry
Field: Environmental Science
Domain: Physical Sciences
Open Access status: green
OpenAlex ID: W7018260658