Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Food processing/contact materials contaminate food with substances such as polycyclic aromatic hydrocarbons (PAHs), brominated flame retardants (BFRs) and per- and polyfluoroalkyl substances (PFAS), but their long-term role in cancer development remains unclear. This study investigated the associations between dietary exposures to these contaminants, alone and in mixtures, and cancer incidence in the French NutriNet-Santé cohort. Methods We assessed cumulative time-dependent exposures to 51 food contaminants using repeated 24h-dietary records from 103,212 participants (78.6% women, mean age=42.1 y, SD = 14.5) of the NutriNet-Santé cohort (2009-2024), and quantitative analyses in food matrices from the French total diet study 2 (2006-2009). Associations between contaminant exposures (sex-specific tertiles) and cancer incidence were characterized using multivariable Cox proportional hazards models adjusted for known risk factors. Mixtures effects were explored using sparse PLS-Cox models. Results Over a median follow-up time of 7.9 y, 4,438 incident cases of cancer were ascertained. Higher exposure to dietary BFRs was associated with increased incidence of overall (HRT3 vs. T1=1.11, 95% CI[1.02-1.20], ptrend=0.02), colorectal (1.47[1.12-1.93],ptrend=0.002) and obesity-related cancers (1.23[1.10-1.37],poverall<0.001). Total PFAS (1.25[1.00-1.58],poverall=0.048) and total PAHs (1.21[1.02-1.43],ptrend=0.03) were associated with higher breast cancer incidence. 20 contaminants were associated with at least one cancer location. Sparse PLS-Cox models identified contaminants mixtures most associated with each specific cancer. Conclusions This large prospective cohort study suggests a potential role for food contaminants such as PFAS, PAHs and BFRs, in cancer development, which is supported by previous in vivo/in vitro experiments showing their interference in key carcinogenesis mechanisms. These elements advocate for stronger regulations, pending further confirmation. Key messages • This large prospective cohort study suggests a potential role for food contaminants such as PFAS, PAHs and BFRs, in cancer development. • These elements advocate for stronger regulations, pending further confirmation.
Institutions: Inserm, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche Épidémiologie et Statistique, Université Paris Cité, Health and Functional Exposomics, Centre National de la Recherche Scientifique, Muséum national d'Histoire naturelle, École Nationale Vétérinaire de Toulouse, Ecole d'Ingénieurs de PURPAN, Toxicologie Alimentaire, Université de Toulouse, Food Packaging Forum Foundation
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7223654521