Annual Meeting of the NCI Cohort Consortium (Abstract Submission): Submission #6

Lightning Talks Abstract
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Presenter's First Name: : Cody









Presenter's Last Name:: Watling









Title (eg: professor, assistant professor, chair, etc):: Postdoctoral Fellow









Degree(s): MSc., DPhil.









Contact Email:: cody.watling@gmail.com









Organization:: National Cancer Institute









Project Title:: Circulating per- and polyfluoroalkyl substances and risk of liver cancer: a nested case- control analysis of individual participant data from 12 prospective cohorts









Additional Authors:
1. First Name: Jessica
   Middle Initial: L
   Last Name: Petrick
   Degree(s): PhD
   Organization: Boston University
2. First Name: Barry
   Middle Initial: I
   Last Name: Graubard
   Degree(s): PhD
   Organization: National Cancer Institute
3. Last Name: Liver Cancer Pooling Project Collaborators
4. First Name: Dinesh
   Last Name: Barupal
   Degree(s): PhD
   Organization: Icahn School of Medicine at Mount Sinai
5. First Name: Katherine
   Middle Initial: A
   Last Name: McGlynn
   Degree(s): PhD
   Organization: National Cancer Institute










Abstract::
Background: Per- and polyfluoroalkyl substances (PFAS) have been associated with numerous deleterious health outcomes including liver damage. However, whether exposure to PFAS is related to liver cancer risk remains unclear.

Methods: We conducted a nested case-control study among 12 prospective cohort studies located in the United States. Pre-diagnostic PFAS, namely perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorohexanesulfonate (PFHxS), were measured among 853 liver cancer cases and 853 matched control participants. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable-adjusted conditional logistic regression for liver cancer risk by study-specific quartiles of concentrations and per 90th vs. 10th percentile incremental increase.

Results:
In the main multivariable-adjusted model, circulating PFOS, PFOA, and PFHxS concentrations were not associated with liver cancer risk (OR per 90th vs. 10th percentile increase:1.00, 95% CI: 0.79-1.28; 0.92, 0.73-1.15; and 0.95, 0.75-1.21, respectively). However, when analyses were stratified by sex, PFOA concentrations were positively associated with liver cancer risk in males (OR per 90th vs. 10th percentile increase:1.62 95% CI:1.07-2.45), whereas an inverse association was observed amongst females (OR per 90th vs. 10th percentile increase:0.68, 0.50-0.92). Analyses separating liver cancer subtypes, hepatocellular carcinoma (HCC) and intrahepatic
cholangiocarcinoma, showed no evidence of heterogeneity although associations were stronger but not significant for HCC. No evidence of heterogeneity was observed by time to diagnosis, body mass index, alcohol intake, ethnicity, or diabetes status.

Conclusions: In the largest study to date, none of the measured circulating PFAS were associated with liver cancer risk; however, PFOA associations appeared to differ by sex.