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Itoh H, Harada KH, Kasuga Y, Yokoyama S, Onuma H, Nishimura H, Kusama R, Yokoyama K, Zhu J, Harada Sassa M, Tsugane S, Iwasaki M. Serum perfluoroalkyl substances and breast cancer risk in Japanese women: A case-control study. Sci Total Environ 2021; 800:149316. [PMID: 34392213 DOI: 10.1016/j.scitotenv.2021.149316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) may contribute to causing breast cancer; however, associations between exposure to PFASs and risk of breast cancer are controversial. OBJECTIVES In the present study, we newly distinguished branched isomers of PFASs from their linear isomers and aimed to investigate the association between serum PFAS concentrations and breast cancer risk in Japanese women. METHODS We used a case-control design to study 405 eligible matched pairs attending four hospitals in Nagano Prefecture, Japan from May 2001 to September 2005. We used in-port arylation gas-chromatography mass spectrometry with negative chemical ionization to measure serum concentrations of 20 PFAS congeners. We calculated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of breast cancer and its hormone-receptor subtypes by quartiles or tertiles of serum PFASs. RESULTS After multivariable adjustment for breast cancer risk factors, we found that serum concentrations of 20 PFAS congeners were significantly inversely associated with risk of breast cancer. Comparing the extreme quartiles of linear isomers of perfluorooctane sulfonate or perfluorooctanoic acid, ORs were 0.15 (95% CI: 0.07, 0.33 P for trend <0.0001) and 0.21 95% CI: 0.10, 0.44 P for trend <0.0001). Among postmenopausal women, whereas we found the linear isomer of perfluorotridecanoic acid to be inversely associated with breast cancer risk, a medium degree of exposure to the branched isomer of perfluorotridecanoic acid was associated with a marginally increased risk of breast cancer (OR [95% CI] = 1.74 [0.98, 3.09]). DISCUSSION In our case-control study, we found overall no association between serum PFAS concentrations and increased risk of breast cancer. Many inverse associations between serum PFAS concentrations and breast cancer risk were found.
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Affiliation(s)
- Hiroaki Itoh
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Tokyo, Japan; Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | - Kouji H Harada
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshio Kasuga
- Department of Surgery, Nagano Matsushiro General Hospital, Nagano, Japan; Department of Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Shiro Yokoyama
- Department of Breast and Thyroid Surgery, Nagano Red Cross Hospital, Nagano, Japan
| | - Hiroshi Onuma
- Department of Breast and Thyroid Surgery, Nagano Red Cross Hospital, Nagano, Japan
| | - Hideki Nishimura
- Department of Chest Surgery and Breast Surgery, Nagano Municipal Hospital, Nagano, Japan
| | - Ritsu Kusama
- Department of Surgery, Hokushin General Hospital, Nakano, Nagano, Japan
| | - Kazuhito Yokoyama
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Epidemiology and Social Medicine, International University of Health and Welfare Graduate School of Public Health, Tokyo, Japan
| | - Jing Zhu
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Sanitary Technology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Mariko Harada Sassa
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Motoki Iwasaki
- Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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