ArticleJournal of exposure science & environmental epidemiology2025
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.
Article in Journal of exposure science & environmental epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed.
- Review
- Handling of multicohort data in pooled analysis of environmental exposures: confounding by cohort of the relationship between perfluoroalkyl substances and birthweight in the ECHO Program.American journal of epidemiology · 2026Article
- A Legacy of Exposure: Lactational PFAS Transfer and Early-Life Accumulation in Northern Elephant Seals.Environment & health (Washington, D.C.) · 2026Article
- Article
- Metal-Organic Frameworks, Covalent Organic Frameworks, and Metal-Covalent Organic Frameworks for Aqueous PFAS Adsorption: Synthesis, Structural Engineering, and Remediation Performance.Materials (Basel, Switzerland) · 2026Review
- AOP-Based Analysis of Curated Transcriptomic Data Reveals a Context-Dependent Core Mechanism of PFAS-Induced Liver Steatosis.Environmental science & technology · 2026Article
- Chemical exposures as risk factors for the development of thyroid cancer.The oncologist · 2026Review
- Spatial analysis of residential location at birth, PFAS in public water, and childhood cancers in Southern California (2000-2019).Journal of exposure science & environmental epidemiology · 2026Article
- Per- and Polyfluoroalkyl Substances Exposure and Ischemic Heart Disease: Emerging Evidence from the Literature.Antioxidants (Basel, Switzerland) · 2026Review
- Identification and quantification of PFAS in the tap water of a French City, Besançon.Environmental monitoring and assessment · 2026Article
- Association of Blood Levels of Forever Plastics with Lung Cancer Mortality among Ever Smokers in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cohort Study.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Per- and polyfluoralkylated substances (PFAS) and other emerging contaminants in groundwater from central urban areas of São Paulo city, Brazil.Environmental monitoring and assessment · 2026Article
- Per- and polyfluoroalkyl substances (PFAS): persistence, toxicity, and emerging solutions.Bioprocess and biosystems engineering · 2026Review
- Current Status of Per- and Poly-Fluoroalkyl Substances (PFAS) Exposure on Lung Cell Biology and Pulmonary Outcomes along Human Health Risk Assessment Steps.Current allergy and asthma reports · 2026Review
- Recent advances in pretreatment technologies for the analysis of per- and polyfluoroalkyl substances.Analytical and bioanalytical chemistry · 2026Review
- Why Is Colorectal Cancer Occurring Earlier? Metabolic Dysfunction, Underrecognized Carcinogens, and Emerging Controversies.Current obesity reports · 2026Review
- Forever Chemicals, Finite Defenses: PFAS Burden the Liver, Break Mitochondria, and Outpace Modern Regulation.International journal of molecular sciences · 2026Review
- PFOS and PFOA exposure induces liver injury and sex-dependent immune effects in C57BL/6 mice.iScience · 2026Article
- Per- and polyfluoroalkyl substances in drinking water and cancer prevalence in the United States.Environmental health : a global access science source · 2026Article
- Burden of tracheal, bronchus, and lung cancer based on GBD 2021.Discover oncology · 2026Article
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8 authors.
Funding
Abstract
backgroundExposure to per- and polyfluoroalkyl substances (PFAS) has been linked with various cancers. Assessment of PFAS in drinking water and cancers can help inform biomonitoring and prevention efforts.
objectiveTo screen for incident cancer (2016-2021) and assess associations with PFAS contamination in drinking water in the US.
methodsWe obtained county-level age-adjusted cancer incidence (2016-2021) from the Surveillance, Epidemiology, and End Results (SEER) Program. Data on PFAS levels in public drinking water systems were obtained from the Third (UCMR3; 2013-2015) and Fifth (UCMR5; 2023-2024) Unregulated Contaminant Monitoring Rule. UCMR3 measured PFOS, PFOA, PFNA, PFHxS, PFHpA, and PFBS. UCMR5 expanded measurements to include PFBA, PFHxA, PFPeA, and PFPeS. We created indicators of PFAS detection and, for UCMR5, concentrations above Maximum Contaminant Levels (MCLs). MCLs for PFOA and PFOS are 4 ng/L, and for PFNA and PFHxS are 10 ng/L. We used Poisson regression models to assess associations between PFAS detection or MCL violation and cancer incidence, adjusting for potential confounders. We estimated the number of attributable cancer cases.
resultsPFAS in drinking water was associated with increased cancer incidence in the digestive, endocrine, oral cavity/pharynx, and respiratory systems. Incidence rate ratios (IRRs) ranged from 1.02 to 1.33. The strongest association was observed between PFBS and oral cavity/pharynx cancers (IRR: 1.33 [1.04, 1.71]). Among males, PFAS was associated with cancers in the urinary, brain, leukemia, and soft tissues. Among females, PFAS was associated with cancers in the thyroid, oral cavity/pharynx, and soft tissue. PFAS in drinking water is estimated to contribute to 4626 [95% CI: 1,377, 8046] incident cancer cases per year based on UCMR3 data and 6864 [95% CI: 991, 12,804] based on UCMR5. IMPACT STATEMENT: The ecological study examined the associations between PFAS in drinking water measured in two waves (2013-2015 and 2023-2024) and cancer incidence between 2016 and 2021. We found that PFAS in drinking water was associated with cancers in the organ system including the oral cavity/pharynx, lung, digestive system, brain, urinary system, soft tissue, and thyroid. Some cancers have not been widely studied for their associations with PFAS. We also observed sex differences in the associations between PFAS and cancer risks. This is the first ecological study that examined PFAS exposure in drinking water and various cancer risks.
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