Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar:194:110690.
doi: 10.1016/j.envres.2020.110690. Epub 2020 Dec 30.

PFAS and cancer, a scoping review of the epidemiologic evidence

Kyle Steenland  1 , Andrea Winquist  2
Affiliations

PFAS and cancer, a scoping review of the epidemiologic evidence

Kyle Steenland et al. Environ Res. 2021 Mar.

Abstract

Background: The number of studies addressing per- and polyfluoroalkyl substances (PFAS) and cancer is increasing. Many communities have had water contaminated by PFAS, and cancer is one of the important community concerns related to PFAS exposure.

Objectives: We critically reviewed the evidence relating to PFAS and cancer from an epidemiologic standpoint to highlight directions for future research that would be the most likely to meaningfully increase knowledge.

Methods: We conducted a search in PubMed for studies of cancer and PFAS (through 9/20/2020). We identified epidemiologic studies that provided a quantitative estimate for some measure of the association between PFAS and cancer. Here, we review that literature, including several aspects of epidemiologic study design that impact the usefulness of study results.

Results: We identified 16 cohort (or case-cohort) studies, 10 case-control studies (4 nested within cohorts and 6 non-nested), 1 cross sectional study and 1 ecologic study. The cancer sites with the most evidence of an association with PFAS are testicular and kidney cancer. There are also some suggestions in a few studies of an association with prostate cancer, but the data are inconsistent.

Discussion: Each study's design has strengths and limitations. Weaknesses in study design and methods can, in some cases, lead to questionable associations, but in other cases can make it more difficult to detect true associations, if they are present. Overall, the evidence for an association between cancer and PFAS remains sparse. A variety of studies with different strengths and weaknesses can be helpful to clarify associations between PFAS and cancer. Long term follow-up of large-sized cohorts with large exposure contrasts are most likely to be informative.

Keywords: Cancer; PFAS; PFOA; PFOS; Review.

PubMed Disclaimer

References

    1. Alexander BH, Olsen GW. Bladder cancer in perfluorooctanesulfonyl fluoride manufacturing workers. Ann Epidemiol. 2007. June;17(6):471–8. - PubMed
    1. Alexander BH, Olsen GW, Burris JM, Mandel JH, Mandel JS. Mortality of employees of a perfluorooctanesulphonyl fluoride manufacturing facility. Occup Environ Med. 2003. October;60(10):722–9. - PMC - PubMed
    1. Andersson EM, Scott K, Xu Y, Li Y, Olsson DS, Fletcher T, Jakobsson K. High exposure to perfluorinated compounds in drinking water and thyroid disease. A cohort study from Ronneby, Sweden. Environ Res. 2019. September;176:108540. - PubMed
    1. Applebaum KM, Malloy EJ, Eisen EA. Left truncation, susceptibility, and bias in occupational cohort studies. Epidemiology 2011;22(4):599–606. - PMC - PubMed
    1. Arrieta-Cortes R, Farias P, Hoyo-Vadillo C, Kleiche-Dray M. Carcinogenic risk of emerging persistent organic pollutant perfluorooctane sulfonate (PFOS): a proposal of classification. Regulatory Toxicology and Pharmacology 2017;83:66–80. - PubMed

Publication types