title: Perfluorooctanoic acid (PFOA) exposures and incident cancers among adults living near a chemical plant.
abstract: BACKGROUND
  Perfluorooctanoic acid (PFOA) is a synthetic chemical ubiquitous in the serum of U.S. residents. It causes liver, testicular, and pancreatic tumors in rats. Human studies are sparse.
  
  
  OBJECTIVE
  We examined cancer incidence in Mid-Ohio Valley residents exposed to PFOA in drinking water due to chemical plant emissions.
  
  
  METHODS
  The cohort consisted of adult community residents who resided in contaminated water districts or worked at a local chemical plant. Most participated in a 2005-2006 baseline survey in which serum PFOA was measured. We interviewed the cohort in 2008-2011 to obtain further medical history. Retrospective yearly PFOA serum concentrations were estimated for each participant from 1952 through 2011. Self-reported cancers were validated through medical records and cancer registry review. We estimated the association between cancer and cumulative PFOA serum concentration using proportional hazards models.
  
  
  RESULTS
  Participants (n = 32,254) reported 2,507 validated cancers (21 different cancer types). Estimated cumulative serum PFOA concentrations were positively associated with kidney and testicular cancer [hazard ratio (HR) = 1.10; 95% CI: 0.98, 1.24 and HR = 1.34; 95% CI: 1.00, 1.79, respectively, for 1-unit increases in ln-transformed serum PFOA]. Categorical analyses also indicated positive trends with increasing exposures for both cancers: for kidney cancer HRs for increasing exposure quartiles were 1.0, 1.23, 1.48, and 1.58 (linear trend test p = 0.18) and for testicular cancer, HRs were 1.0, 1.04, 1.91, 3.17 (linear trend test p = 0.04).
  
  
  CONCLUSIONS
  PFOA exposure was associated with kidney and testicular cancer in this population. Because this is largely a survivor cohort, findings must be interpreted with caution, especially for highly fatal cancers such as pancreatic and lung cancer.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Vaughn
authors.initials: V
authors.lastname: Barry
authors.forename: Andrea
authors.initials: A
authors.lastname: Winquist
authors.forename: Kyle
authors.initials: K
authors.lastname: Steenland
mesh_terms: D000328:Adult; D002210:Caprylates / Q000097:blood / Q000633:toxicity*; D002617:Chemical Industry / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004781:Environmental Exposure / Q000032:analysis*; D005466:Fluorocarbons / Q000097:blood / Q000633:toxicity*; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D016016:Proportional Hazards Models; D014874:Water Pollutants, Chemical / Q000097:blood / Q000633:toxicity*; D014903:West Virginia / Q000453:epidemiology
chemical_list: D002210:Caprylates; D005466:Fluorocarbons; D014874:Water Pollutants, Chemical; C023036:perfluorooctanoic acid