Per- and polyfluoroalkyl substances (PFAS) exposure and thyroid cancer risk

BACKGROUND: Although per- and polyfluoroalkyl substances (PFAS) exposure is a potential contributor to the increasing thyroid cancer trend, limited studies have investigated the association between PFAS exposure and thyroid cancer in human populations. We therefore investigated associations between plasma PFAS levels and thyroid cancer diagnosis using a nested case-control study of patients with thyroid cancer with plasma samples collected at/before cancer diagnosis. METHODS: 88 patients with thyroid cancer using diagnosis codes and 88 healthy (non-cancer) controls pair-matched on sex, age (±5 years), race/ethnicity, body mass index, smoking status, and year of sample collection were identified in the BioMe population (a medical record-linked biobank at the Icahn School of Medicine at Mount Sinai in New York); 74 patients had papillary thyroid cancer. Eight plasma PFAS were measured using untargeted analysis with liquid chromatography-high resolution mass spectrometry and suspect screening. Associations between individual PFAS levels and thyroid cancer were evaluated using unconditional logistic regression models to estimate adjusted odds ratios (OR adj) and 95% confidence intervals (CI). FINDINGS: There was a 56% increased rate of thyroid cancer diagnosis per doubling of linear perfluorooctanesulfonic acid (n-PFOS) intensity (OR adj, 1.56, 95% CI: 1.17-2.15, P = 0.004); results were similar when including patients with papillary thyroid cancer only (OR adj, 1.56, 95% CI: 1.13-2.21, P = 0.009). This positive association remained in subset analysis investigating exposure timing including 31 thyroid cancer cases diagnosed ≥1 year after plasma sample collection (OR adj, 2.67, 95% CI: 1.59-4.88, P < 0.001). INTERPRETATION: This study reports associations between exposure to PFAS and increased rate of (papillary) thyroid cancer. Thyroid cancer risk from PFAS exposure is a global concern given the prevalence of PFAS exposure. Individual PFAS studied here are a small proportion of the total number of PFAS supporting additional large-scale prospective studies investigating thyroid cancer risk associated with exposure to PFAS chemicals. FUNDING: National Institutes of Health grants and The Andrea and Charles Bronfman Philanthropies

The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis

Perfluoroalkyl acids (PFAS) are known endocrine disrupting chemicals, potentially affecting thyroid function. Smoking has been associated with PFAS levels as well as with thyroid function. The impact of smoking on the association between PFAS and thyroid function remains to be elucidated, so the objective was to assess the effect of PFAS exposure on thyroid function in the general population, stratified by smoking status, using the National Health and Nutrition Examination Survey (NHANES). NHANES adult participants who were part of the 2011&ndash;2012 laboratory subsample and had PFAS and thyroid function measured were included (n = 1325). Adjusted linear regression models and stratified analyses were performed. There was a significant positive association between perfluorooctanesulfonic acid (PFOS) (p = 0.003), perfluorononanoic acid (PFNA) (p = 0.014), total PFAS (p = 0.004) concentrations and free T4 (FT4). No significant associations were found between perfluorooctanoic acid (PFOA), PFOS, perfluorohexane sulfonate (PFHxS), PFNA, total PFAS and total T4 (TT4) or thyroid stimulating hormone (TSH). In non-smokers, a significant positive association was found between PFOS (p = 0.003), PFHxS (p = 0.034), PFNA (p = 0.012), total PFAS (p = 0.003) and FT4 while no significant associations were found in smokers. The present study showed that increased PFAS exposure was associated with increased FT4 in non-smokers, while no association was found in smokers. These results confirm that smoking modifies the association between PFAS exposure and thyroid function

Per- and Polyfluoroalkyl Substances (PFAS) in Community Water Systems (CWS) and the Risk of Thyroid Cancer: An Ecological Study.

Thyroid cancer incidence has been steadily increasing over the past decade in the United States (US). A discussion exists regarding the potential contribution of exposure to endocrine-disrupting chemicals, encompassing certain per- and poly-fluoroalkyl substances (PFASs). This ecological study evaluated the potential correlation between PFAS levels in drinking water and thyroid cancer incidence in the US. Data on age-adjusted thyroid cancer incidence rate (per 100,000 persons) by county were obtained from the Centers for Disease Control and Prevention (CDC) for US counties with available data in 2015-2019. Data on PFAS concentrations in the drinking water of selected community water systems (CWSs) were obtained from the CDC National Environmental Public Health Tracking Network in 2013-2015. The correlation between PFASs in CWSs and thyroid cancer incidence was calculated using Spearman correlation. A statistically significant correlation was found between perfluorooctanoic acid (PFOA) (r = 0.031; p = 0.043), perfluorononanoic acid (PFNA) (r = 0.058; p ≤ 0.001), and thyroid cancer incidence. The results suggest a potential link between certain PFAS exposures and thyroid cancer risk. However, due to the nature of an ecological study, no conclusions can be drawn at the individual level or causality. More research is needed, particularly on an individual level to allow for more detailed exposure assessment

Per- and Polyfluoroalkyl Substances (PFAS) in Community Water Systems (CWS) and the Risk of Thyroid Cancer: An Ecological Study

Thyroid cancer incidence has been steadily increasing over the past decade in the United States (US). A discussion exists regarding the potential contribution of exposure to endocrine-disrupting chemicals, encompassing certain per- and poly-fluoroalkyl substances (PFASs). This ecological study evaluated the potential correlation between PFAS levels in drinking water and thyroid cancer incidence in the US. Data on age-adjusted thyroid cancer incidence rate (per 100,000 persons) by county were obtained from the Centers for Disease Control and Prevention (CDC) for US counties with available data in 2015–2019. Data on PFAS concentrations in the drinking water of selected community water systems (CWSs) were obtained from the CDC National Environmental Public Health Tracking Network in 2013–2015. The correlation between PFASs in CWSs and thyroid cancer incidence was calculated using Spearman correlation. A statistically significant correlation was found between perfluorooctanoic acid (PFOA) (r = 0.031; p = 0.043), perfluorononanoic acid (PFNA) (r = 0.058; p ≤ 0.001), and thyroid cancer incidence. The results suggest a potential link between certain PFAS exposures and thyroid cancer risk. However, due to the nature of an ecological study, no conclusions can be drawn at the individual level or causality. More research is needed, particularly on an individual level to allow for more detailed exposure assessment

Correlation between Lindane Use and the Incidence of Thyroid Cancer in the United States: An Ecological Study

The increasing rate of thyroid cancer may be attributable to endocrine disruptive chemicals. Lindane is a persistent organochlorine pesticide with endocrine disruptive properties that has been classified as carcinogenic to humans. The aim of this ecological study was to evaluate potential correlation between lindane exposure and thyroid cancer incidence in the United States (US). Data on statewide age-adjusted thyroid cancer incidence rate (per 100,000 people) was obtained from the Centers for Disease Control and Prevention for all US states for 2019. Lindane use estimates per cropland (kg/acres cropland) were then overlaid on the map of age-adjusted thyroid cancer incidence rate using ArcGIS. The trend of lindane use in the US between 1992 and 2007 was calculated using the Mann Kendall correlation test. The correlation between statewide lindane use and age-adjusted thyroid cancer incidence rates was calculated using Spearman correlation. Lindane use in the US decreased significantly between 1992 and 2007 (T = &minus;0.617; p &lt; 0.001). There was no statistically significant correlation between lindane use in 1992 and thyroid cancer incidence rate for any of the years between 1999 and 2019. Our results suggest that restrictions clearly seem to be effective in reducing lindane use, however, more research is needed for individual pesticides and thyroid cancer

High Thyroid Cancer Incidence Rate in a Community near a Landfill: A Descriptive Epidemiological Assessment

Background: to investigate the high thyroid cancer incidence rate of Staten Island and to disentangle the effects of potential environmental exposure from a landfill from screening. Methods: age-adjusted thyroid cancer incidence rates obtained from the New York State Public Access Cancer Epidemiology Data for New York State (NYS) excluding New York City (NYC) and the five NYC boroughs, including Staten Island, were mapped over time (1995&ndash;2018), investigated per age group and by percentage of localized thyroid cancer. Changes in trends were assessed using joinpoint. Contaminants of concern on Staten Island were assessed for carcinogenic and endocrine disruptive properties. Results: a more pronounced thyroid cancer incidence rate increase, without a difference in age distribution and similar percentages of localized thyroid cancer, was found in Staten Island compared to its demographic equivalent (NYS excluding NYC). Multiple contaminants of concern with carcinogenic and endocrine disrupting properties (e.g., cadmium, lead) were identified in air, water and sediment samples. Conclusion: investigations into the effects of increased/sustained environmental exposures are needed in chronically exposed populations to identify potential mechanisms of action of certain pollutants

French pediatricians' knowledge, attitudes, beliefs towards and practices in the management of weight problems in children

A representative sample of 611 French pediatricians was interviewed on their knowledge, attitudes, beliefs towards and practices regarding childhood obesity through a 39-item Likert format questionnaire. A vast majority of the respondents regarded obesity as an illness (86.4%), 70.2% were aware that without any treatment an obese child has a high risk to remain obese in adulthood, 84% reported that managing obesity is part of their responsibility in the routine practice and 89.3% affirmed to systematically inform parents of obese children on health risks associated with obesity. At the same time, 82.4% were convinced that managing obesity is bound to fail and only 46.5% that it is professionally gratifying. However, doctors who followed a vocational training dedicated to obesity felt themselves more efficient in managing childhood obesity (p Obesity management Pediatricians Primary care KABP Prevention