Food-processing/packaging related contaminants and incidence of cancer in the NutriNet-Santé prospective cohort
LE FOLCALVEZ X. 1, ARNAULT N. 1, HASENBÖHLER A. 1, AGAËSSE C. 1, PAYEN DE LA GARANDERIE M. 1, SHAH S. 1, SZABO DE EDELENYI F. 1, YVROUD-HOYOS P. 1, BOIZOIT-SZANTAI C. 2, GAUVREAU-BÉZIAT J. 3, COUMOUL X. 4, FINI J. 5, PIERRE F. 6, MUNCKE J. 7, BORTOLI S. 4, ZELEK L. 1,8, HERCBERG S. 1, DESCHASAUX-TANGUY M. 1, SROUR B. 1, TOUVIER M. 1
1 Université Sorbonne Paris Nord, Université Paris Cité, INSERM, INRAE, CNAM, Centre de Recherche en Epidémiologie and Statistiques (CRESS), Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Bobigny, France; 2 UMR Paris-Saclay Applied Economics, INRAE, Palaiseau, France; 3 French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Food Observatory Unit, Maisons-Alfort, France; 4 Université Paris Cité, INSERM, Health & Functional Exposomics - HealthFex, Paris, France; 5 PhyMa Unit, CNRS UMR 7221, Muséum National d’Histoire Naturelle, Paris, France; 6 Toxalim, Université de Toulouse, INRAE, ENVT, EI-Purpan, Toulouse, France; 7 Food Packaging Forum Foundation, Zurich, Switzerland; 8 Oncology department, Avicenne Hospital, AP-HP, Bobigny, France
Background
Our food is contaminated by several substances (polycyclic aromatic hydrocarbons – PAHs, per- and polyfluorinated compounds – PFAS, brominated flame retardants – BFRs, acrylamide), all its way through the processing, the packaging and the cooking. However, the long-term implication of these contaminants on cancer incidence remains unclear.
Objectives
This study aimed to investigate the associations between dietary exposure to these contaminants and cancer incidence in a large French cohort.
Methods
Anthropometric, socio-demographic, physical activity and health data of 103,212 participants (78.6% women, mean age=42.1 years, SD=14.5) aged above 15 years old were collected from the French prospective cohort NutriNet-Santé (2009-2024). We assessed dietary intakes using repeated 24h-dietary records and exposures to food contaminants using food composition databases and quantitative analysis from the total diet study (EAT 2) led by the French Agency for Food, Environmental and Occupational Health & Safety (ANSES, 2009). We characterised associations between exposures to food contaminants and cancer incidence using multivariable proportional hazards Cox models adjusted for known risk factors.
Results
Over a median follow-up period of 8 years, 4,438 cases of cancer were identified. Several single BFRs, PFAS and PAHs were associated with higher incidence of overall, colorectal, breast and prostate cancers. For instance, BDE47 was associated with higher incidence of cancer in all studied cancer locations (HRT3 vs. T1 = 1.32 95% CI: [1.05-1.67], p-trend = 0.02 - results for prostate cancer). Total BFRs was associated with higher incidence of overall and breast cancer (1.11 [1.02-1.20], p-trend = 0.02 - results for overall cancer). Likewise, total PAHs was associated with higher incidence of overall and breast cancer (1.21 [1.02-1.43], p-trend = 0.03 - results for breast cancer). A positive association was detected between exposure to certain PAHs such as phenanthrene and incidence of overall and breast cancer (1.19 [1.08-1.30], p-trend < 0.001 - results for overall cancer). Among PFAS, PFDoA and PFBS were associated with a higher incidence of overall cancer (1.12 [0.99-1.27], p-trend = 0.04 and 1.16 [1.05-1.29], p-trend = 0.005, respectively). Exposure to total PFAS was associated with a higher incidence of breast cancer (1.25 [1.00-1.58], p-value = 0.05). Potential mixtures effects are currently being explored by sPLSCox.
Conclusions/Implications for practice or policy
This study suggests that food contaminants likely to originate from processing and food contact materials, such as PAHs, BFRs, or PFAS, may play a role in the etiology of cancers. These observations are consistent with the endocrine-disrupting potential of these contaminants and argue in favour of stricter regulation of these food contaminants.