Recommended Citation
Robinson A, Ehrenpreis ED, Anderson E. PFAS Exposure and Gastrointestinal Cancer: A Population-Based Exploratory Study. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/ Significance:
Per- and polyfluoroalkyl substances (PFAS) are persistent environmental pollutants known as “forever chemicals.” PFAS accumulate in human tissue and have potential for carcinogenesis. Prior studies have examined the effects of environmental exposure to PFAS on human disease and suggest a link between PFAS exposure and breast and thyroid cancer, but associations with gastrointestinal (GI) malignancies have not been assessed.
Purpose:
We conducted a geographic ecological analysis to examine correlations between PFAS concentrations and the incidence of GI and other cancers across the United States.
Methods:
County-level cancer incidence rates for multiple cancers were merged with maximum PFAS drinking water concentration data. Data for individual PFAS were collected from the U.S. Environmental Protection Agency. Cancer incidence data were obtained from the National Cancer Institute's and the Center for Disease Control’s cancer statistics programs. GI cancers included colorectal, pancreatic, liver, oropharyngeal, and gastric cancer; thyroid and breast cancer served as non-GI comparators. A cleaned dataset was analyzed, and Pearson correlation coefficients (r), associated p-values, and number of available data points (n) were determined for individual PFAS compound exposures across all cancer types.
Results:
Among all cancer types, colorectal cancer incidence showed a statistically significant positive correlation with maximum PFTA levels (r = 0.456, p = 0.0002, n = 61). Weaker positive correlations were observed between oropharyngeal cancer and maximum PFTA (r = 0.338, p = 0.0089, n = 59) and PFTrDA levels (r = 0.357, p = 0.0417, n = 33). No other GI cancer showed statistically significant associations with individual PFAS compounds. Among non-GI cancers, correlations were weak and not statistically significant. When all GI cancers were combined, the correlation with maximum PFTA was not significant (r = 0.20, p = 0.12, n = 51).
Conclusion:
This population-level exploratory study found a statistically significant association between maximum PFTA exposure and colorectal cancer rates across 61 counties. PFTA is a long-chain PFAS with high environmental persistence and bioaccumulation potential yet remains one of the least studied and least regulated PFAS. These findings suggest a potential specific association between PFTA exposure and colorectal carcinogenesis and highlight the need for further mechanistic studies, broader population level assessments, and improved monitoring and regulation.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
PFAS Exposure and Gastrointestinal Cancer: A Population-Based Exploratory Study
Background/ Significance:
Per- and polyfluoroalkyl substances (PFAS) are persistent environmental pollutants known as “forever chemicals.” PFAS accumulate in human tissue and have potential for carcinogenesis. Prior studies have examined the effects of environmental exposure to PFAS on human disease and suggest a link between PFAS exposure and breast and thyroid cancer, but associations with gastrointestinal (GI) malignancies have not been assessed.
Purpose:
We conducted a geographic ecological analysis to examine correlations between PFAS concentrations and the incidence of GI and other cancers across the United States.
Methods:
County-level cancer incidence rates for multiple cancers were merged with maximum PFAS drinking water concentration data. Data for individual PFAS were collected from the U.S. Environmental Protection Agency. Cancer incidence data were obtained from the National Cancer Institute's and the Center for Disease Control’s cancer statistics programs. GI cancers included colorectal, pancreatic, liver, oropharyngeal, and gastric cancer; thyroid and breast cancer served as non-GI comparators. A cleaned dataset was analyzed, and Pearson correlation coefficients (r), associated p-values, and number of available data points (n) were determined for individual PFAS compound exposures across all cancer types.
Results:
Among all cancer types, colorectal cancer incidence showed a statistically significant positive correlation with maximum PFTA levels (r = 0.456, p = 0.0002, n = 61). Weaker positive correlations were observed between oropharyngeal cancer and maximum PFTA (r = 0.338, p = 0.0089, n = 59) and PFTrDA levels (r = 0.357, p = 0.0417, n = 33). No other GI cancer showed statistically significant associations with individual PFAS compounds. Among non-GI cancers, correlations were weak and not statistically significant. When all GI cancers were combined, the correlation with maximum PFTA was not significant (r = 0.20, p = 0.12, n = 51).
Conclusion:
This population-level exploratory study found a statistically significant association between maximum PFTA exposure and colorectal cancer rates across 61 counties. PFTA is a long-chain PFAS with high environmental persistence and bioaccumulation potential yet remains one of the least studied and least regulated PFAS. These findings suggest a potential specific association between PFTA exposure and colorectal carcinogenesis and highlight the need for further mechanistic studies, broader population level assessments, and improved monitoring and regulation.
Affiliations
Advocate Lutheran General Hospital