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Association between urinary perchlorate and malignancies of endocrine-related tissues in U.S. adults: analysis of National Health and Nutrition Examination Survey (NHANES) data

Year: 2025

Type: article

Abstract: Background: Perchlorate is a persistent environmental contaminant and endocrine disruptor that inhibits iodine uptake through the sodium iodide symporter. While its thyroid toxicity is well recognized, evidence regarding its association with malignancies of endocrine-related tissues is limited. This study aimed to investigate the relationship between urinary perchlorate and the occurrence of thyroid cancer and pancreatic cancer in a nationally representative U.S. adult population. Methods: Data from 20,316 adults in the National Health and Nutrition Examination Survey (NHANES; 2003 to 2018) were analyzed. Urinary perchlorate was measured using ion chromatography with electrospray tandem mass spectrometry. Urinary perchlorate levels were creatinine-corrected before analysis. Weighted multivariable logistic regression was applied to assess associations with self-reported physician-diagnosed thyroid cancer and pancreatic cancer. Bayesian correlation analysis was performed for pancreatic cancer and thyroid cancer due to the small number of cases. Restricted cubic spline models were used to explore dose-response relationships. Results: The normalized urinary perchlorate level was significantly associated with both thyroid (P=0.041) and pancreatic cancer (P<0.001). This association remained significant across models when analyzed by quartiles [thyroid cancer: odds ratio (OR) =3.81, 95% confidence interval (CI): 1.26-11.5, P=0.02; pancreatic cancer: OR =13.4, 95% CI: 1.13-159, P=0.04]. Bayesian analysis provided robust evidence supporting these associations (Bayes factor: thyroid cancer =139.525; pancreatic cancer =176.853). No clear dose-response relationship was observed for either cancer type. Conclusions: Perchlorate exposure was associated with both thyroid and pancreatic cancers. This study provides evidence supporting its potential role in endocrine-related carcinogenesis and underscores the need for further research and exposure-reduction strategies.

Source: Translational Cancer Research

DOI: 10.21037/tcr-2025-1785