Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Environ Pollut. 2022 Aug 1;306:119345. doi: 10.1016/j.envpol.2022.119345. Epub 2022 Apr 23.
Experimental studies have suggested perfluoroalkyl substances (PFASs) as mammary toxicants, but few studies evaluated the prospective associations of PFASs with breast cancer risk. We performed a case-cohort study within the Dongfeng-Tongji cohort, including incident breast cancer cases (n = 226) and a random sub-cohort (n = 990). Baseline plasma concentrations of four perfluorinated carboxylic acids (PFCAs) [perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroheptanoic acid (PFHpA)] and two perfluorinated sulfonic acids (PFSAs) [perfluorooctane sulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS)] were measured. Barlow-weighted Cox regression models revealed that each 1-unit increase in ln-transformed PFOA and PFHpA was associated with a separate 35% and 20% elevated incident risk of breast cancer [HR(95%CI) = 1.35(1.03, 1.78) and 1.20(1.02, 1.40), respectively], which were also significant among postmenopausal females [HR(95%CI) = 1.34(1.01, 1.77) and 1.23 (1.02, 1.48), respectively]. Quantile g-computation analysis observed a 19% increased incident risk of breast cancer along with each simultaneous quartile increase in all ln-transformed PFCA concentrations [HR(95%CI) = 1.19(1.01, 1.41)], with PFOA accounting for 56% of the positive effect. Our findings firstly revealed the impact of short-chain PFHpA on increased incident risk of breast cancer, suggested exposure to PFASs as a risk factor for breast cancer, and shed light on breast cancer prevention by regulating PFASs as a chemical class.
实验研究表明全氟烷基物质（PFAS）是一种乳腺毒物，但很少有研究评估 PFAS 与乳腺癌风险的前瞻性关联。我们在东风-同济队列中进行了病例-队列研究，包括 226 例乳腺癌新发病例和 990 名随机亚队列。测量了 4 种全氟羧酸（PFCAs）[全氟辛酸（PFOA）、全氟壬酸（PFNA）、全氟癸酸（PFDA）和全氟庚酸（PFHpA）]和 2 种全氟磺酸（PFSAs）[全氟辛烷磺酸（PFOS）和全氟己烷磺酸（PFHxS）]的基线血浆浓度。巴洛加权 Cox 回归模型显示，ln 转换的 PFOA 和 PFHpA 每增加 1 个单位，乳腺癌的发病风险分别升高 35%和 20%[风险比（95%置信区间）分别为 1.35（1.03，1.78）和 1.20（1.02，1.40）]，绝经后女性也有显著差异[风险比（95%置信区间）分别为 1.34（1.01，1.77）和 1.23（1.02，1.48）]。分位数 g 计算分析观察到，随着所有 ln 转换的 PFCAs 浓度同时增加一个四分位数，乳腺癌的发病风险增加 19%[风险比（95%置信区间）为 1.19（1.01，1.41）]，其中 PFOA 占正效应的 56%。我们的研究结果首次揭示了短链 PFHpA 对乳腺癌发病风险增加的影响，表明 PFAS 暴露是乳腺癌的一个风险因素，并为通过调节 PFAS 作为一个化学类别来预防乳腺癌提供了启示。
