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

IntroductionThe 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).MethodsA logistic regression analysis was performed. A directed acyclic graph was plotted to adjust for the potential confounders.ResultsThe 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.DiscussionConsidering 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.