Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China.
Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China.
Environ Res. 2024 Dec 1;262(Pt 2):119909. doi: 10.1016/j.envres.2024.119909. Epub 2024 Sep 1.
As persistent organic pollutants (POPs), perfluoroalkyl substances (PFAS) may potentially impact human health. Our study aimed to investigate the prospective association between PFAS exposure and the incidence risk of breast cancer in females.
By fully following the Jinchang Cohort after a decade, we conducted this nested case-control study with 135 incidence cases of breast cancer (BC) and 540 bias-paired controls. The PFAS levels were tested by baseline serum samples. Conditional logistic regression and a restricted cubic spline model were employed to investigate the BC incidence risks and the dose-response associated with single PFAS component exposure. Furthermore, the Quantile g-computation model (Qgc), random forest model (RFM), and bayesian kernel machine regression models (BKMR) were integrated to estimate the mixed effects of PFAS exposure on the incidence risk of BC.
Exposures to specific PFAS components were positively associated with an increased incidence risk of breast cancer. By grouping the study population into different baseline menopausal statuses, PFHxS, PFNA, PFBA, PFUdA, PFOS, and PFDA demonstrated a similarly positive correlation with BC incidence risks. However, the increased incidence risks of BC associated with PFOA, PFOS, PFUdA, and 9CL-PF3ONS exposure were exclusively found in the premenopausal population. Both BKMR and Qgc revealed that exposure to mixed PFAS was associated with an increased risk of breast cancer, with Qgc specifically indicating an odds ratio (OR) of 2.21 (95% CI: 1.53, 3.19). Random forests showed that PFBA, PFOS, PFHxS, and PFDA emerged as predominant factors potentially influencing breast cancer incidence.
Our findings suggest a strong association between PFAS exposure and the incidence of breast cancer. Premenopausal women should exercise more caution regarding PFAS exposure.
作为持久性有机污染物（POPs），全氟烷基物质（PFAS）可能会对人类健康产生潜在影响。我们的研究旨在调查 PFAS 暴露与女性乳腺癌（BC）发病风险之间的前瞻性关联。
通过对金昌队列进行 10 年的全面随访，我们进行了这项嵌套病例对照研究，共有 135 例乳腺癌（BC）发病病例和 540 例偏倚配对对照。PFAS 水平通过基线血清样本进行检测。采用条件 logistic 回归和限制性立方样条模型，研究单一 PFAS 成分暴露与 BC 发病风险的相关性及其剂量-反应关系。此外，还采用 Quantile g 计算模型（Qgc）、随机森林模型（RFM）和贝叶斯核机器回归模型（BKMR）来估计 PFAS 暴露对 BC 发病风险的混合效应。
特定 PFAS 成分的暴露与乳腺癌发病率的增加呈正相关。将研究人群分为不同的基线绝经状态，PFHxS、PFNA、PFBA、PFUdA、PFOS 和 PFDA 与 BC 发病率的相关性也呈正相关。然而，PFOA、PFOS、PFUdA 和 9CL-PF3ONS 暴露与 BC 发病风险的增加仅见于绝经前人群。BKMR 和 Qgc 均表明，混合 PFAS 暴露与乳腺癌发病风险增加相关，其中 Qgc 特别表明比值比（OR）为 2.21（95%CI：1.53，3.19）。随机森林显示，PFBA、PFOS、PFHxS 和 PFDA 是潜在影响乳腺癌发病的主要因素。
我们的研究结果表明，PFAS 暴露与乳腺癌发病之间存在很强的关联。绝经前妇女应更加警惕 PFAS 暴露。
