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PFAS Levels and Kidney Cancer Risk in the Multiethnic Cohort Study

, by Elise Tookmanian, Ph.D.

Vials of blood lie on a blank background with the chemical structures of three PFAS (PFOS, PFNA, and PFOA) drawn next to them.

Chemical structures of three PFAS: PFOS, PFNA, and PFOA. 

Per- and polyfluoroalkyl substances (PFAS) are environmentally persistent organic pollutants detectable in the blood of most U.S. adults. Most studies of the effects of PFAS on cancer risk have focused on cohorts of predominantly non-Hispanic White participants. Leveraging data from the Multiethnic Cohort Study (MEC), researchers in the Occupational and Environmental Epidemiology Branch (OEEB) led the first study to explore the relationship between blood levels of commonly detected PFAS and risk of kidney cancer in individuals from different racial and ethnic groups. The findings were published in Environment International on September 14, 2023.  

This study was jointly led by research fellow Jongeun Rhee, Sc.D., M.S., postdoctoral fellow Vicky Chang, Ph.D., M.P.H., and senior investigators Mark Purdue, Ph.D., and Jonathan Hofmann, Ph.D., M.P.H., in OEEB. Previously, this research team found that higher concentrations of perfluorooctanoate (PFOA), a widely studied PFAS, in blood was associated with higher risk of kidney cancer in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which included mostly non-Hispanic White individuals. The makeup of the MEC is very different, comprising five different racial and ethnic groups (African American, 16 %, Japanese American, 26 %; Latino, 22 %; Native Hawaiian, 6 %; and non-Hispanic White, 23 %). In the MEC, the investigators found no association between levels of PFOA in the blood and kidney cancer risk overall. However, a positive association between PFOA and risk of kidney cancer was observed among non-Hispanic White participants, the subgroup most similar to the population in PLCO.

Interestingly, the researchers also found that higher blood levels of perfluorononanoate (PFNA), another frequently detected PFAS, were associated with a suggestive increased risk of kidney cancer in the study population  This association was strongest among African American participants, a group known to have higher incidence of kidney cancer. African American participants also had higher concentrations of PFNA and perfluorooctane sulfonate (PFOS) compared to non-Hispanic White participants, consistent with observations from the National Health and Nutrition Examination Survey (NHANES). These findings highlight the importance of evaluating the effects of PFAS exposures in racially and ethnically diverse populations. This research was supported in part by a Pamela Anne Cafritz Renal Cell Carcinoma Award, received by Drs. Hofmann and Rhee. 


Rhee J*, Chang VC* et al. Serum concentrations of per- and polyfluoroalkyl substances and risk of renal cell carcinoma in the Multiethnic Cohort Study. Environ Int. 2023.