Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Aug 5;193(8):1182-1196.
doi: 10.1093/aje/kwae010.

Exposure to per- and polyfluoroalkyl substances and breast cancer risk: a systematic review and meta-analysis of epidemiologic studies

Che-Jung Chang  1 , Jennifer L Ish  1 , Vicky C Chang  2 , Meklit Daniel  1 , Rena R Jones  2 , Alexandra J White  1
Affiliations
Meta-Analysis

Exposure to per- and polyfluoroalkyl substances and breast cancer risk: a systematic review and meta-analysis of epidemiologic studies

Che-Jung Chang et al. Am J Epidemiol. .

Abstract

We synthesized the epidemiologic evidence on the associations between per- and polyfluoroalkyl substances (PFAS) exposure and breast cancer risk. Our systematic review and meta-analysis included 18 and 11 articles, respectively, covering studies up to February 2023. The summary relative risks (RRs) estimated by random-effects meta-analyses did not support an association between PFAS and overall breast cancer risk (eg, a natural log (ln)-unit increase in serum/plasma concentrations [ng/mL] for perfluorooctanoate [PFOA] RR = 0.95; 95% CI, 0.77-1.18; perfluorooctane sulfonate [PFOS] RR = 0.98; 95% CI, 0.87-1.11). However, when limiting to studies that assessed exposures prior to a breast cancer diagnosis, we observed a positive association with PFOA (a ln-unit increase, RR = 1.16; 95% CI, 0.96-1.40). We also observed some possible heterogeneous associations by tumor estrogen and progesterone receptor status among postmenopausal breast cancer cases. No meaningful changes were observed after excluding the studies with high risk of bias (Tier 3). Based on the evaluation tool developed by the National Toxicology Program, given the heterogeneity across studies and the variability in timing of exposure measurements, the epidemiologic evidence needed to determine the association between PFAS exposure and breast cancer remains inadequate. Our findings support the need for future studies with improved study designs to determine this association.

Keywords: PFAS; breast cancer; epidemiologic study; meta-analysis; per- and polyfluoroalkyl substances; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Similar articles

See all similar articles

Cited by

References

    1. World Cancer Research . Worldwide cancer data. 2023. Accessed June 28, 2023. https://www.wcrf.org/cancer-trends/worldwide-cancer-data/
    1. Ellington TD, Miller JW, Henley SJ, et al. Trends in breast cancer incidence, by race, ethnicity, and age among women aged ≥20 years—United States, 1999–2018. MMWR Morb Mortal Wkly Rep. 2022;71(2):43–47. 10.15585/mmwr.mm7102a2 - DOI - PMC - PubMed
    1. Collaborative Group on Hormonal Factors in Breast Cancer . Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol. 2012;13(11):1141–1151. 10.1016/S1470-2045(12)70425-4 - DOI - PMC - PubMed
    1. Lambe M, Hsieh C, Chan H, et al. Parity, age at first and last birth, and risk of breast cancer: a population-based study in Sweden. Breast Cancer Res Treat. 1996;38(3):305–311. 10.1007/BF01806150 - DOI - PubMed
    1. Mørch LS, Skovlund CW, Hannaford PC, et al. Contemporary hormonal contraception and the risk of breast cancer. N Engl J Med. 2017;377(23):2228–2239. 10.1056/NEJMoa1700732 - DOI - PubMed