IARC 60th Anniversary - 19-21 May 2026
Session : Environmental and occupational cancer: an underestimated burden?
Perfluorooctanoic acid and cancer incidence in a cohort in the mid-Ohio Valley
HOFMANN J. 1, TAN Y. 2, BARRY V. 2, TAYLOR A. 3, WINQUIST A. 4, HYER M. 3, GRAUBARD B. 1, STEENLAND K. 2, SILVERMAN D. 1
1 U.S. National Cancer Institute, Rockville, United States; 2 Emory University, Atlanta, United States; 3 Information Management Services, Inc, Calverton, United States; 4 Mercer School of Medicine, Columbus, United States
Background: Perfluorooctanoic acid (PFOA) has been classified as a human carcinogen based partly on limited epidemiologic evidence of increased kidney and testicular cancer risk.
Objectives: We conducted an updated analysis of cancer incidence in a high PFOA-exposed cohort of community members and workers in the mid-Ohio Valley with follow-up extended an additional 10 years and linkage to the Virtual Pooled Registry to better characterize risk of malignancies of a priori interest and to identify risk of other cancers.
Methods: Based on estimates of annual serum PFOA concentrations during 1952-2020, we evaluated associations between cumulative PFOA exposure and site-specific cancer incidence through 2020 among 32,050 participants (28,398 community members and 3,652 workers). Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models adjusted for potential confounding factors.
Results: In the overall study population, we observed positive associations with kidney and testicular cancers. Associations with kidney cancer for high PFOA exposure were most pronounced among younger community members (≤60 years: fourth vs. first quartile, HR-Q4=1.82, 95% CI 1.02-3.26; P-trend=0.03) and those with localized disease (HR-Q4=1.72, 95% CI 1.01-2.95; P-trend=0.17). High PFOA exposure was also associated with increased testicular cancer risk among community members (HR-Q4=3.62, 95% CI 1.03-12.7; P-trend=0.12). We also observed positive associations with thyroid cancer, particularly among female participants, and with pancreatic cancer among older participants; exposure-response relationships for these malignancies were strongest among workers (per 1-unit increase on the natural log scale, HR-cont=1.79, 95% CI 1.07-2.97; and HR-cont=1.70, 95% CI 1.08-2.67 for thyroid and pancreatic cancers, respectively).
Conclusions: Our findings in this high PFOA-exposed cohort provide additional epidemiologic evidence of increased kidney and testicular cancer risk, as well as new evidence of associations with thyroid and pancreatic cancers. These findings have important implications regarding our understanding of the carcinogenic potential of PFOA and the cancer burden related to this ubiquitous environmental contaminant.