Invited Perspective: The Slow Road to Finding Out Whether the “Forever” Chemicals Cause Chronic Disease

• Type of Material: Article
• Authors: Nelson Steenland, Emory University
• Language: English
• Date: 2023-07-01
• Publisher: EHP
• Publication Version: Final Published Version
• Copyright Statement: EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted.
• Final Published Version (URL): http://dx.doi.org/10.1289/EHP13212
• Title of Journal or Parent Work: Environmental Health Perspectives
• Volume: 131
• Issue: 7
• Start Page: 71305
• End Page: 71305
• Keywords: Chronic Disease; Humans

Abstract

Testicular and kidney cancer are the two cancer types with the strongest evidence for an association with per- and polyfluoroalkyl substances (PFAS), although the literature remains rather sparse for both.1,2 The article in this issue of Environmental Health Perspectives by Purdue et al.3—which describes testicular cancer among active-duty U.S. Air Force servicemen in relation to PFAS exposure—provides a valuable contribution to the literature. The authors conducted a relatively large case–control study of 530 individuals with testicular cancer whose cancer was diagnosed during active service (age 18–39 y) and matched controls. Purdue et al. took advantage of serum samples routinely banked for all service members to assess the association of testicular cancer with prediagnostic PFAS serum concentrations. Most of the serum samples were taken shortly after the study participants began their service. For an additional 187 cases and controls, the authors analyzed a second prediagnostic serum sample taken on average 6 y after military service began. First serum samples of PFAS were compared to PFAS serum data from the National Health and Nutrition Examination Survey (NHANES), which reflect levels in the general population, and levels were found to be similar. Second samples were similar to first, and of subjects had fire-fighting jobs, which led to higher exposure. So, in essence, this was a low-exposure population. In their case–control analyses, the authors found a positive trend in risk for testicular cancer by serum perfluorooctanesulfonic acid (PFOS) using the first samples ( ) and a more marked monotonic positive trend ( ) when analyzing second samples, after adjusting for other PFAS.