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Serum PFAS Associated with Testicular Cancer Risk in U.S. Air Force Servicemen

, by Elise Tookmanian, Ph.D.

A U.S. Airmen aim a hose shooting firefighting foam.

U.S. Airmen aim a hose shooting firefighting foam. 

Credit: U.S. Navy

Per- and polyfluoroalkyl substances (PFAS), chemicals that are highly persistent in the environment, are a component of firefighting foams used at airports and military installations to extinguish petroleum-based fires. There has been concern over possible health effects from exposures to PFAS, including elevated risks of cancers of the kidney and testis. Mark Purdue, Ph.D., senior investigator in the Occupational and Environmental Epidemiology Branch and colleagues at the Uniformed Services University, led a nested case-control study to investigate the relationship between blood levels of PFAS among active-duty Air Force servicemen and testicular cancer. The researchers found that elevated blood levels of perfluorooctanesulfonic acid (PFOS), a specific type of PFAS, was associated with higher risk of developing this cancer type. These findings were published in Environmental Health Perspectives in July 2023. 

Testicular cancer is the most frequently diagnosed cancer among U.S. active-duty servicemen and among young adult men in general. Epidemiological evidence has suggested an association between PFAS and testicular cancer, but this is the first study to investigate this relationship using blood measurements and within a military population. The researchers selected 530 cases diagnosed during active duty and 530 cancer-free matched controls with prediagnostic blood samples from the Department of Defense Serum Repository. The researchers discovered elevated levels of some PFAS in the blood was associated with serving as a firefighter or at a base with high levels of PFAS in the water supply. While the researchers found that higher blood concentrations of PFOS was associated with increased risk of developing testicular cancer, other PFAS showed no association with risk of developing testicular cancer. 

These findings motivate continued examination of PFOS exposure and risk of testicular cancer in military and other highly exposed populations. 


Purdue MP et al. A nested case–control study of serum per- and polyfluoroalkyl substances and testicular germ cell tumors among U.S. Air Force servicemenEnviron Health Perspect. 2023.