Per- and poly-fluoroalkyl substances (PFAS) Exposure and risk of bladder and prostate cancers: A systematic review and meta-analysis

PFAS exposure and bladder and prostate cancer

Abstract

Objectives: PFASs are synthetic chemicals that humans may be exposed to through workplace or the environment. Previous studies have suggested a carcinogenic effect. In our review, we investigated the association between PFAS exposure and risk of bladder and prostate cancer.

Methods: We searched through IARC Monographs, ATSDR documents, and PubMed (up to January 2024) to find studies that examined the relationship between PFAS exposure and bladder and prostate cancer. Four reviewers independently screened studies, extracted data, and evaluated quality using a modified version of the Newcastle-Ottawa Scale (NOS). We conducted meta-analyses using random-effects models, stratified analyses, dose-response assessments, and evaluated publication bias.

Results: We included 21 independent studies in our meta-analysis. The findings didn’t reveal an association between PFOA, PFOS, and PFAS exposure and bladder cancer, as well PFOA, PFNA and prostate cancer. However, we found an association between prostate cancer and total PFAS (RR = 1.12, 95% CI =1.06-1.18), based on two studies, and an association of borderline statistical significance with PFOS (RR = 1.04, 95% CI =0.98-1.11). There was no difference between outcome, region, year of publication, study design, quality score, and gender, exposure source and different levels of PFASs for both cancer types. Publication bias was excluded for prostate cancer studies (P = 0.71) and bladder cancer (P = 0.79).

Conclusion: Our research did not find a link between different types of PFAS exposure and bladder cancer. However, it supports a potential association between PFOS exposure and prostate cancer. Bias and confounding cannot be excluded.