Cited by 150Per- and polyfluoroalkyl substances researchToxic Organic Pollutants ImpactFluorine in Organic Chemistry

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Perfluorooctanoate and Perfluorooctanesulfonate Plasma Levels and Risk of Cancer in the General Danish Population

Eriksen, K. T., Sorensen, M., McLaughlin, J. K., Lipworth, L., Tjonneland, A., Overvad, K., Raaschou-Nielsen, O.·2009·JNCI Journal of the National Cancer Institute

DOI 10.1093/jnci/djp041

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Abstract

Perfluorooctanoate and perfluorooctanesulfonate are used in many industrial products and have been widely detected in human blood. Both chemicals are associated with tumor development in animal studies, but data on carcinogenic potential in humans are sparse. We investigated the association between plasma levels of perfluorooctanoate and perfluorooctanesulfonate and cancer risk within a prospective Danish cohort of participants with no previous cancer diagnosis at enrollment. From enrollment, between December 1, 1993, and May 31, 1997, and through July 1, 2006, we identified 713 participants with prostate cancer, 332 with bladder cancer, 128 with pancreatic cancer, and 67 with liver cancer in the entire cohort and we selected a comparison subcohort of 772. Plasma concentrations of perfluorooctanoate and perfluorooctanesulfonate were measured in each participant by use of high-pressure liquid chromatography coupled to tandem mass spectrometry. We found no clear differences in incidence rate ratios for these cancers in relation to plasma concentrations of perfluorooctanoate or perfluorooctanesulfonate. A 30%-40% increase in risk estimates for prostate cancer was observed for the three upper quartiles of perfluorooctanesulfonate concentration compared with the lowest quartile (eg, for the lowest vs the fourth quartile, incidence rate ratio = 1.38, 95% confidence interval = 0.99 to 1.93). Plasma concentrations of perfluorooctanoate and perfluorooctanesulfonate in the general Danish population appear not to be associated with risk of prostate, bladder, pancreatic, or liver cancer.

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“The review comprised 10 cohort studies [19-21, 23, 25-28, 30, 33], three case-control studies nested in a cohort [22, 29, 32], and two case-control studies [24, 31].”
Background
Per- and polyfluoroalkyl substances and the associated thyroid cancer risk: A case-control study in China
Li, H., Yang, M., Yang, J. G., Seery, S., Ma, C., Liu, Y., Zhang, X., Li, A., & Guo, H. (2023) · Chemosphere · doi:10.1016/j.chemosphere.2023.139411 · Cited by 38
Carcinogenic risk of emerging persistent organic pollutant perfluorooctane sulfonate (PFOS): A proposal of classification
Arrieta-Cortes, R., Farías, P., Hoyo‐Vadillo, C., & Kleiche‐Dray, M. (2016) · Regulatory Toxicology and Pharmacology · doi:10.1016/j.yrtph.2016.11.021 · Cited by 36
“According to SIGN critical appraisal guidelines, out of the ten selected studies only one is considered to be a high-quality [þþ] study (Alexander and Olsen, 2007), five are considered to be acceptable quality [þ] studies (Grice et al., 2007; Eriksen et al., 2009; Bonefeld-Jorgensen et al., 2011; Hardell et al., 2014;…”
BackgroundMethodInfluential
Pollutants: a candidate as a new risk factor for osteoarthritis—results from a systematic literature review
Deprouw, C., Courties, A., Fini, J., Clerget-Froidevaux, M.-S., DEMENEIX, B. A., Berenbaum, F., Sellam, J., & Louati, K. (2022) · RMD Open · doi:10.1136/rmdopen-2021-001983 · Cited by 36
Cholesterol-like Condensing Effect of Perfluoroalkyl Substances on a Phospholipid Bilayer
Shen, Z., Ge, J., Ye, H., Tang, S., & Li, Y. (2020) · The Journal of Physical Chemistry B · doi:10.1021/acs.jpcb.0c00980 · Cited by 38
A prospective nested case-control study of serum concentrations of per- and polyfluoroalkyl substances and aggressive prostate cancer risk
Rhee, J., Barry, K. H., Huang, W., Sampson, J. N., Hofmann, J. N., Silverman, D. T., Calafat, A. M., Botelho, J. C., Kato, K., Purdue, M. P., et al. (2023) · Environmental Research · doi:10.1016/j.envres.2023.115718 · Cited by 35
Analytical methods employed in the identification and quantification of per- and polyfluoroalkyl substances in human matrices - A scoping review
Comito, R., Porru, E., & Violante, F. S. (2023) · Chemosphere · doi:10.1016/j.chemosphere.2023.140433 · Cited by 34
Research and Regulatory Advancements on Remediation and Degradation of Fluorinated Polymer Compounds
Olsavsky, N. J., Kearns, V. M., Beckman, C. P., Sheehan, P. L., Burpo, F. J., Bahaghighat, H. D., & Nagelli, E. A. (2020) · Applied Sciences · doi:10.3390/app10196921 · Cited by 38
Relative rates of cancers and deaths in Australian communities with PFAS environmental contamination associated with firefighting foams: A cohort study using linked data
Law, H. D., Armstrong, B. K., D’Este, C. A., Hosking, R., Smurthwaite, K. S., Trevenar, S. M., Lucas, R. M., Lazarevic, N., Kirk, M., & Korda, R. (2022) · Cancer Epidemiology · doi:10.1016/j.canep.2022.102296 · Cited by 35
PFOS-induced apoptosis through mitochondrion-dependent pathway in human–hamster hybrid cells
Wang, X., Zhao, G., Liang, J., Jiang, J., Chen, N., Yu, J., Wang, Q., Xu, A., Chen, S., & Wu, L. (2013) · Mutation Research/Genetic Toxicology and Environmental Mutagenesis · doi:10.1016/j.mrgentox.2013.04.004 · Cited by 32
“reported that plasma concentrations of PFOS were not associated with risk of liver, prostate, bladder, pancreas cancer in the general Danish population [5], several studies have shown its carcinogenic potential.”
Background
Plasma concentrations of persistent organic pollutants and pancreatic cancer risk
Porta, M. S., Gasull, M., Pumarega, J. A., Kiviranta, H., Rantakokko, P., Raaschou‐Nielsen, O., Bergdahl, I. A., Sandanger, T. M., Agudo, A., Rylander, C., et al. (2021) · International Journal of Epidemiology · doi:10.1093/ije/dyab115 · Cited by 34
Self-citation
Porphyrin-based colorimetric sensing of perfluorooctanoic acid as proof of concept for perfluoroalkyl substance detection
Taylor, C. M., Ellingsen, T. A., Breadmore, M. C., & Kilah, N. L. (2021) · Chemical Communications · doi:10.1039/d1cc04903h · Cited by 31
Perfluorooctane sulfonate promotes doxycycline-induced liver tumor progression in male Kras transgenic zebrafish
Zhu, Y., Yang, D., Duan, X., Zhang, Y., Chen, D., Gong, Z., & Liu, C. (2021) · Environmental Research · doi:10.1016/j.envres.2021.110962 · Cited by 31
Urban Endocrine Disruptors Targeting Breast Cancer Proteins.
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Per- and polyfluorinated substances in the Nordic Countries
Posner, S., Roos, S., Poulsen, P. B., Jörundsdóttir, H. Ó., Gunnlaugsdóttir, H., Trier, X., Jensen, A. A., Katsogiannis, A. A., Herzke, D., Bonefeld‐Jørgensen, E. C., et al. (2013) · doi:10.6027/tn2013-542 · Cited by 31
“Eriksen, 2009 (Eriksen et al., 2009) Denmark men and women prospective 1993– 1997 1,240 (90% women) PFOA.”
Background
Male reproductive system parameters in a two-generation reproduction study of ammonium perfluorooctanoate in rats and human relevance
York, R. G., Kennedy, G. L., Olsen, G. W., & Butenhoff, J. L. (2010) · Toxicology · doi:10.1016/j.tox.2010.03.005 · Cited by 27
Unveiling the emerging concern of per- and polyfluoroalkyl substances (PFAS) and their potential impacts on estuarine ecosystems
Anik, A. H., Basir, M. S., Sultan, M. B., Alam, M., Rahman, M. M., & Tareq, S. M. (2025) · Marine Pollution Bulletin · doi:10.1016/j.marpolbul.2025.117554 · Cited by 24
Pathology Working Group review and evaluation of proliferative lesions of mammary gland tissues in female rats fed ammonium perfluorooctanoate (APFO) in the diet for 2 years
Hardisty, J. F., Willson, G. A., Brown, W. R., McConnell, E. E., Frame, S. R., Gaylor, D. W., Kennedy, G. L., & Butenhoff, J. L. (2010) · Drug and Chemical Toxicology · doi:10.3109/01480541003667610 · Cited by 23
Derivation of a drinking water equivalent level (DWEL) related to the maximum contaminant level goal for perfluorooctanoic acid (PFOA), a persistent water soluble compound
Tardiff, R. G., Carson, M. L., Sweeney, L. M., Kirman, C. R., Tan, Y., Andersen, M. E., Bevan, C. D., & Gargas, M. L. (2009) · Food and Chemical Toxicology · doi:10.1016/j.fct.2009.07.016 · Cited by 24
“In Denmark, three studies examined fetal growth indicators and developmental milestones in relation to maternal exposures to PFOA.”
Influential
The Latest Sensor Detection Methods for per- and Polyfluoroalkyl Substances
Zhang, M., Zhao, Y., Bui, B., Tang, L., Xue, J., Chen, M., & Chen, W. (2024) · Critical Reviews in Analytical Chemistry · doi:10.1080/10408347.2023.2299233 · Cited by 24
Per- and polyfluoroalkyl substances in new firefighter turnout gear textiles
Maizel, A. C., Thompson, A. L., Tighe, M., Veras, S. E., Rodowa, A. E., Falkenstein‐Smith, R., Benner, B. A., Hoffman, K. M., Donnelly, M. K., Hernandez, O., et al. (2023) · doi:10.6028/nist.tn.2248 · Cited by 25
Unveiling the intricate connection between per- and polyfluoroalkyl substances and prostate hyperplasia
Wang, T., Yang, J., Han, Y., & Wāng, Y. (2024) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2024.173085 · Cited by 22
Effects of perfluorinated alkyl acids on cellular responses of MCF-10A mammary epithelial cells in monolayers and on acini formation in vitro
Halsne, R., Tandberg, J. I., Lobert, V. H., Østby, G. C., Thoen, E., Ropstad, E., & Verhaegen, S. (2016) · Toxicology Letters · doi:10.1016/j.toxlet.2016.08.004 · Cited by 20
An overview of the impact of PFAS on animals, humans, and the environment using a One Health approach
Ferretti, F., Barbarossa, A., & Bardhi, A. (2026) · Environmental Science and Pollution Research · doi:10.1007/s11356-026-37412-9 · Cited by 23
“Regarding bladder cancer, studies reported modest but not statistically significant associations between PFOA exposure and bladder cancer, while a Danish cohort study found no link between PFOA plasma levels and an increased risk of developing bladder cancer (Eriksen et al. 2009).”
Exposure to perfluorooctanoic acid leads to promotion of pancreatic cancer
Kamendulis, L. M., Hocevar, J. M., Stephens, M., Sandusky, G. E., & Hocevar, B. A. (2022) · Carcinogenesis · doi:10.1093/carcin/bgac005 · Cited by 20
Phycoerythrin Peptide from Pyropia yezoensis Alleviates Endoplasmic Reticulum Stress Caused by Perfluorooctane Sulfonate-Induced Calcium Dysregulation
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PFAS (per- and polyfluorinated alkyl substances) as EDCs (endocrine-disrupting chemicals) - Identification of compounds with high potential to bind to selected terpenoids NHRs (nuclear hormone receptors)
Buławska, N., Sosnowska, A., Kowalska, D., Stepnik, M., & Puzyn, T. (2024) · Chemosphere · doi:10.1016/j.chemosphere.2024.143967 · Cited by 18
Human Evidence of Perfluorooctanoic Acid (PFOA) Exposure on Hepatic Disease: A Systematic Review and Meta-Analysis
Choi, J., Kim, J., & Lee, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811318 · Cited by 20
“, 2009 [19] Cohort study (prospective) Denmark 1993–2006 Diet, Cancer and Health (DCH) cohort, Patients with prostate, bladder, pancreatic, liver cancer 1240 (prostate cancer n = 713, liver cancer n = 67) Median 59 years (5–95th percentiles: 51–65) PFOA Plasma PFOA (quartile trend) Liver cancer 0.”
Background
Environmental risk factors for liver cancer
McGlynn, K. A., Watling, C. Z., Hernandez, B. Y., & Groopman, J. D. (2025) · Hepatology · doi:10.1097/hep.0000000000001463 · Cited by 17
A case-cohort study of per- and polyfluoroalkyl substance concentrations and incident prostate cancer in the cancer prevention Study-II LifeLink cohort study
Troeschel, A. N., Teras, L. R., Hodge, J. M., Rodriguez, J., Wang, Y., Daniel, J. H., Diver, W. R., & Winquist, A. G. (2024) · Environmental Research · doi:10.1016/j.envres.2024.119560 · Cited by 17
“…three studies investigated the association of serum concentrations of specific types of PFAS in general community settings, where PFAS exposure levels were much lower, with the incident prostate cancer risk, yielding mixed findings (Hardell et al., 2014; Eriksen et al., 2009; Rhee et al., 2023).”
Influential
Toxicological response of Sprague Dawley rats from inhalation exposure to perfluorooctane sulfonyl fluoride (POSF)
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Per‐ and Polyfluoroalkyl Substances (PFAS) in Drinking Water
Kougias, D. G., Killius, A., Collins, J., Russman, E., & Maddaloni, M. A. (2024) · Wiley eBooks · doi:10.1002/9781119742975.ch7 · Cited by 15
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Cholesterol-like effects of a fluorotelomer alcohol incorporated in phospholipid membranes
Jbeily, M., Bärenwald, R., Kreßler, J., Saalwächter, K., & Ferreira, T. M. (2018) · Scientific Reports · doi:10.1038/s41598-018-20511-0 · Cited by 16
Advanced Nanoformulations for Detection and Removal of Poly- and Perfluoroalkyl Substances (PFAS)
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“Similar results were reported in a case study including the general Danish population, which was conducted to assess cancer risk associated with PFOA and PFOS exposure [32].”
Exposure to Per- and Polyfluoroalkyl Substances and Liver Cancer: A Systematic Review of Animal and Epidemiological Studies
Tanghal, R. B., Beglarian, E., Stem, A. D., Aung, M. T., Alderete, T. L., DUCATMAN, A. M., Vasiliou, V., McConnell, R., Conti, D. V., & Chatzi, L. (2026) · Environmental Science & Technology · doi:10.1021/acs.est.5c05535 · Cited by 13
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“We included 17 independent studies (Gilliland and Mandel, 1993; Alexander et al ., 2003; Olsen et al ., 2004; Grice, 2007; Leonard, 2008; Eriksen, 2009; Lundin, 2009; Steenland, 2012, 2015; Barry, 2013; Vieira, 2013; Innes, 2014; Raleigh, 2014; Mastrantonio, 2018; Li, 2022; Law, 2023; Winquist,…”
Pathology review of proliferative lesions of the exocrine pancreas in two chronic feeding studies in rats with ammonium perfluorooctanoate
Rae, J. M. C., Frame, S. R., Kennedy, G. L., Butenhoff, J. L., & Chang, S. (2014) · Toxicology Reports · doi:10.1016/j.toxrep.2014.04.005 · Cited by 11
Epidemiological Findings
Khalil, N., Lee, M., & Steenland, K. (2015) · Molecular and integrative toxicology · doi:10.1007/978-3-319-15518-0_13 · Cited by 12
Per-and polyfluoroalkyl substances (PFAS) in milk and dairy products: a literature review of the occurrence, contamination sources, and health risks
Hossini, H., Massahi, T., Parnoon, K., & Nouri, M. (2025) · Food Additives & Contaminants Part A · doi:10.1080/19440049.2025.2538224 · Cited by 10
“A study of the association between PFAS exposure and cancer in the general population found no link between plasma concentrations of PFOA or PFOS and pancreatic, liver, prostate, or bladder cancers (Eriksen et al. 2009).”
Influence of KRAS mutations, persistent organic pollutants, and trace elements on survival from pancreatic ductal adenocarcinoma
Porta, M. S., Pumarega, J. A., Amaral, A. F. S., Genkinger, J. M., Camargo, J., Mucci, L. A., Alguacil, J., Gasull, M., Zhang, X., Morales, E., et al. (2020) · Environmental Research · doi:10.1016/j.envres.2020.109781 · Cited by 10
“Knowledge is available on possible adverse pancreatic effects of POPs and other contaminants (Amaral et al., 2012; Antwi et al., 2015; Barone et al., 2016; Benetou et al., 2018; Eriksen et al., 2009; Gasull et al., 2018, 2019; Gore et al., 2015; Hardell et al., 2007; Porta, 2006).”
Background
How well does a single blood sample represent long-term exposure for epidemiological studies of PFOA among men in the general population?
Bartell, S. M., Purdue, M. P., Rhee, J., Nøst, T. H., Rusiecki, J. A., & Steenland, K. (2024) · Environment International · doi:10.1016/j.envint.2024.109056 · Cited by 9

Authors: Eriksen, K. T., Sorensen, M., McLaughlin, J. K., Lipworth, L., Tjonneland, A., Overvad, K., & Raaschou-Nielsen, O.
Affiliations: Aarhus University Hospital (DK)
ORCID: McLaughlin, J. K.
Lipworth, L.
Overvad, K.
Venue: JNCI Journal of the National Cancer Institute
Publisher: Oxford University Press (OUP)
Published: 2009-04-07
Volume: 101
Issue: 8
Pages: 605-609
ISSN: 0027-8874 (ISSN-L)
1460-2105
DOI: 10.1093/jnci/djp041
OpenAlex: W2098197528
Cited by: 150
References: 25
Citations by year: 2026: 13 · 2025: 15 · 2024: 17 · 2023: 12 · 2022: 14 · 2021: 11 · 2020: 7 · 2019: 2 · 2018: 6 · 2017: 5 · 2016: 3 · 2015: 8 · 2014: 11 · 2013: 10 · 2012: 7
FWCI: 4.06
Type: journal article
Language: en
Open access: closed
Locations: JNCI Journal of the National Cancer Institute (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: 3M
Topics: Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
Physical Sciences › Chemistry › Organic Chemistry › Fluorine in Organic Chemistry
Keywords: perfluorooctanoic acid, PFOS, perfluorinated compounds, plasma concentration, cancer risk, prostate cancer, bladder cancer, pancreatic cancer, liver cancer, prospective cohort, carcinogenicity, biomarkers of exposure
MeSH terms: Aged, Analysis of Variance, Urinary Bladder Neoplasms, Caprylates, Chromatography, High Pressure Liquid, Denmark, Environmental Pollutants, Female, Fluorocarbons, Humans, Liver Neoplasms, Male, Middle Aged, Neoplasms, Pancreatic Neoplasms, Prospective Studies, Prostatic Neoplasms, Risk Factors, Cohort Studies, Incidence, Odds Ratio, Alkanesulfonic Acids, Risk Assessment

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Perfluorooctanoate and Perfluorooctanesulfonate Plasma Levels and Risk of Cancer in the General Danish Population

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