ArticleBMC cancer2014
Inverse association of colorectal cancer prevalence to serum levels of perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) in a large Appalachian population.
Article in BMC cancer, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Per- and poly-fluoroalkyl substances exposure and risk of gastrointestinal cancers: a systematic review and meta-analysis.European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2025Pooled it
- Plasma metabolomic signatures of all and cause-specific cancers: a multi-platform population-based study.Metabolomics : Official journal of the Metabolomic Society · 2026Article
- Per- and polyfluoroalkyl substances mixture exposure is associated with colorectal cancer TNM stage.Frontiers in toxicology · 2026Article
- Circulating per- and polyfluoroalkyl substances and risk of pancreatic cancer: A nested case-control study within the NYU Women's health study.Environmental pollution (Barking, Essex : 1987) · 2025Article
- A scoping review on per- and poly-fluoroalkyl substances (PFAS) and colorectal cancer: Evidence from in vitro, animal, and epidemiological studies.Environment international · 2025Article
- Circulating per- and polyfluoroalkyl substances and liver cancer risk: a nested case-control analysis of individual participant data from 12 prospective cohorts.Environmental health perspectives · 2025Article
- Associations between per-and polyfluoroalkyl substances (PFAS) and county-level cancer incidence between 2016 and 2021 and incident cancer burden attributable to PFAS in drinking water in the United States.Journal of exposure science & environmental epidemiology · 2025Article
- Perfluoroalkyl and polyfluoroalkyl substances and Cancer risk: results from a dose-response Meta-analysis.Journal of environmental health science & engineering · 2024Article
- How the Structure of Per- and Polyfluoroalkyl Substances (PFAS) Influences Their Binding Potency to the Peroxisome Proliferator-Activated and Thyroid Hormone Receptors-An In Silico Screening Study.Molecules (Basel, Switzerland) · 2023Article
- The role of perfluorooctane sulfonic acid (PFOS) exposure in inflammation of intestinal tissues and intestinal carcinogenesis.Frontiers in toxicology · 2023Review
- Perfluorooctanoic Acid Disrupts Ovarian Steroidogenesis and Folliculogenesis in Adult Mice.Toxicological sciences : an official journal of the Society of Toxicology · 2022Article
- Risk of Cancer in a Community Exposed to Per- and Poly-Fluoroalkyl Substances.Environmental health insights · 2022Article
- PFAS and cancer, a scoping review of the epidemiologic evidence.Environmental research · 2021Article
- Risk to human health related to the presence of perfluorooctane sulfonic acid and perfluorooctanoic acid in food.EFSA journal. European Food Safety Authority · 2018Article
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- Human serum levels of perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) in Uyghurs from Sinkiang-Uighur Autonomous Region, China: background levels study.Environmental science and pollution research international · 2015Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPerfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) are persistent environmental contaminants that affect metabolic regulation, inflammation, and other factors implicated in the development and progression of colorectal cancer (CRC). However, the link between these compounds and CRC remains unknown. In this cross-sectional study, we investigated the association of CRC diagnosis to PFOA and PFOS blood levels in a large Appalachian population.
methodsParticipants were 47,359 adults ≥ 21 years of age and residing in six PFOA-contaminated water districts in the mid-Ohio Valley (N = 47,151 cancer-free adults, 208 cases of primary CRC). All participants completed a comprehensive health survey between 2005 and 2006; serum levels of PFOA, PFOS, and a range of other blood markers were also measured. Medical history was assessed via self report and cancer diagnosis confirmed via chart review.
resultsCRC showed a strong inverse, dose-response association with PFOS serum levels (odds ratio (OR) adjusted for potential confounders = 0.2, 95% confidence interval (CI) 0.2,0.3) for highest vs. lowest quartile of PFOS, P-trend < 0.00001) and a significant, but more modest inverse association with PFOA (adjusted OR = 0.6 (CI 0.4, 0.9) for highest vs. lowest quartile, P-trend = 0.001). These inverse associations were stronger in those diagnosed within the previous 6 years and resident in the same water district for a minimum of 10-15 years preceding assessment. The relationship between PFOA and CRC was also more pronounced in men and leaner adults, and showed a stronger linear trend at lower exposure levels.
conclusionsIn this large cross-sectional study, we found a strong, inverse association between PFOS and likelihood of CRC diagnosis and a significant, although more modest inverse association between PFOA and CRC. If confirmed in prospective investigations, these findings may aid in identifying new strategies for CRC prevention and treatment and inform future studies regarding mechanisms underlying CRC pathogenesis.
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