Background

Some hormonally active cancers have low survival rates, but a large proportion of their incidence remains unexplained. Endocrine disrupting chemicals may affect hormone pathways in the pathology of these cancers.

Objective

To evaluate cross-sectional associations between per- and polyfluoroalkyl substances (PFAS), phenols, and parabens and self-reported previous cancer diagnoses in the National Health and Nutrition Examination Survey (NHANES).

Methods

We extracted concentrations of 7 PFAS and 12 phenols/parabens and self-reported diagnoses of melanoma and cancers of the thyroid, breast, ovary, uterus, and prostate in men and women (≥20 years). Associations between previous cancer diagnoses and an interquartile range increase in exposure biomarkers were evaluated using logistic regression models adjusted for key covariates. We conceptualized race as social construct proxy of structural social factors and examined associations in non-Hispanic Black, Mexican American, and other Hispanic participants separately compared to White participants.

Results

Previous melanoma in women was associated with higher PFDE (OR:2.07, 95% CI: 1.25, 3.43), PFNA (OR:1.72, 95% CI: 1.09, 2.73), PFUA (OR:1.76, 95% CI: 1.07, 2.89), BP3 (OR: 1.81, 95% CI: 1.10, 2.96), DCP25 (OR: 2.41, 95% CI: 1.22, 4.76), and DCP24 (OR: 1.85, 95% CI: 1.05, 3.26). Previous ovarian cancer was associated with higher DCP25 (OR: 2.80, 95% CI: 1.08, 7.27), BPA (OR: 1.93, 95% CI: 1.11, 3.35) and BP3 (OR: 1.76, 95% CI: 1.00, 3.09). Previous uterine cancer was associated with increased PFNA (OR: 1.55, 95% CI: 1.03, 2.34), while higher ethyl paraben was inversely associated (OR: 0.31, 95% CI: 0.12, 0.85). Various PFAS were associated with previous ovarian and uterine cancers in White women, while MPAH or BPF was associated with previous breast cancer among non-White women.

Impact Statement

Biomarkers across all exposure categories (phenols, parabens, and per- and poly- fluoroalkyl substances) were cross-sectionally associated with increased odds of previous melanoma diagnoses in women, and increased odds of previous ovarian cancer was associated with several phenols and parabens. Some associations differed by racial group, which is particularly impactful given the established racial disparities in distributions of exposure to these chemicals. This is the first epidemiological study to investigate exposure to phenols in relation to previous cancer diagnoses, and the first NHANES study to explore racial/ethnic disparities in associations between environmental phenol, paraben, and PFAS exposures and historical cancer diagnosis.

中文翻译：

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NHANES 研究参与者中酚类、对羟基苯甲酸酯以及全氟烷基和多氟烷基物质与既往癌症诊断相关的探索性概况

背景

一些荷尔蒙活跃的癌症的存活率很低，但其中很大一部分的发病率仍然无法解释。内分泌干​​扰化学物质可能会影响这些癌症病理学中的激素途径。

客观的

评估全氟烷基物质和多氟烷基物质 (PFAS)、苯酚和对羟基苯甲酸酯与国家健康和营养检查调查 (NHANES) 中自我报告的既往癌症诊断之间的横截面关联。

方法

我们提取了 7 种 PFAS 和 12 种苯酚/对羟基苯甲酸酯的浓度，以及男性和女性（≥20 岁）黑色素瘤和甲状腺癌、乳腺癌、卵巢癌、子宫癌和前列腺癌的自我报告诊断。使用针对关键协变量调整的逻辑回归模型评估了既往癌症诊断与暴露生物标志物四分位数范围增加之间的关联。我们将种族概念化为结构性社会因素的社会建构代理，并分别与白人参与者相比，研究了非西班牙裔黑人、墨西哥裔美国人和其他西班牙裔参与者的关联。

结果

女性既往黑色素瘤与较高的 PFDE (OR:2.07, 95% CI: 1.25, 3.43)、PFNA (OR:1.72, 95% CI: 1.09, 2.73)、PFUA (OR:1.76, 95% CI: 1.07, 2.89）、BP3（OR：1.81，95% CI：1.10、2.96）、DCP25（OR：2.41，95% CI：1.22、4.76）和 DCP24（OR：1.85，95% CI：1.05、3.26）。既往卵巢癌与较高的 DCP25 (OR: 2.80, 95% CI: 1.08, 7.27)、BPA (OR: 1.93, 95% CI: 1.11, 3.35) 和 BP3 (OR: 1.76, 95% CI: 1.00, 3.09) 相关）。既往子宫癌与 PFNA 增加相关（OR：1.55，95% CI：1.03，2.34），而较高的尼泊金乙酯含量则呈负相关（OR：0.31，95% CI：0.12，0.85）。各种 PFAS 与白人女性既往卵巢癌和子宫癌有关，而 MPAH 或 BPF 与非白人女性既往乳腺癌有关。

影响报告

所有暴露类别（苯酚、对羟基苯甲酸酯以及全氟烷基和多氟烷基物质）的生物标志物与女性先前诊断出黑色素瘤的几率增加有关，并且先前患卵巢癌的几率增加与几种苯酚和对羟基苯甲酸酯有关。一些协会因种族群体而异，考虑到这些化学品接触分布的种族差异，这一点尤其具有影响力。这是第一项调查苯酚暴露与既往癌症诊断之间关系的流行病学研究，也是第一项 NHANES 研究，探讨环境苯酚、对羟基苯甲酸酯和 PFAS 暴露与既往癌症诊断之间关系的种族/民族差异。