Cody Z Watling, Jessica L Petrick, Barry I Graubard, Hyokyoung G Hong, Xuehong Zhang, Matthew J Barnett, Mollie E Barnard, Yu Chen, A Heather Eliassen, J Michael Gaziano, Wen-Yi Huang, Jae H Kang, Jill Koshiol, I-Min Lee, Erikka Loftfield, Steven C Moore, Lorelei A Mucci, Marian L Neuhouser, Christina C Newton, Howard D Sesso, Martha Shrubsole, Rashmi Sinha, Lesley Tinker, Matthew Triplette, Caroline Y Um, Kala Visvanathan, Jean Wactawski-Wende, Eleanor L Watts, Walter C Willett, Fen Wu, Wei Zheng, Peter T Campbell, Jonathan N Hofmann, Mark P Purdue, Dinesh Barupal, Katherine A McGlynn
Epidemiologic studies of PFAS and liver cancer risk have produced conflicting results with no strong or clear associations for pre-diagnostic perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorohexanesulfonate (PFHxS). We now report analyses of nine additional PFAS in a nested case-control study within 12 prospective cohorts (853 cases, 853 matched controls) in the United States. Using multivariable-adjusted conditional logistic regression, we estimated odds ratios per 90th vs. 10th percentile increase in PFAS levels. Perfluoroheptanoic acid (PFHpA) was positively associated with liver cancer risk (OR: 1.78, 95% CI: 1.26-2.52); no associations were observed for other PFAS. Significant heterogeneity was observed by sex, cancer subtype, and time from blood collection. Associations were stronger among males (OR: 3.72, 95% CI: 2.10-6.59), for hepatocellular carcinoma (4.53, 2.59-7.94), and for those diagnosed ≤10 years after blood collection (3.17, 1.80-5.57). Given continued use of short-chain PFAS in consumer products, further research on their effects on liver health is warranted.