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Table 4 Invasive breast cancer risk associated with PFAS concentrations, by menopausal statusa

From: Breast cancer risk and serum levels of per- and poly-fluoroalkyl substances: a case-control study nested in the California Teachers Study

PFAS Serum Concentration

Postmenopausal (n = 1657)

Pre- or Peri-menopausal (n = 102)

# cases

Crude Odds Ratio (OR) b

Adjusted Odds Ratio (OR) d

# cases

Crude Odds Ratio (OR) b

Adjusted Odds Ratio (OR) e

OR (95% CI)

p-valuec

OR (95% CI)

p-valuec

OR (95% CI)

p-valuec

OR (95% CI)

p-valuec

PFOA

 Low

306

1.00

0.27

1.00

0.49

25

1.00

0.77

1.00

0.62

 Medium

287

0.868 (0.682, 1.103)

0.889 (0.689, 1.147)

11

0.881 (0.318, 2.443)

0.888 (0.239, 3.302)

 High

266

0.870 (0.679, 1.116)

0.912 (0.699, 1.189)

7

0.859 (0.264, 2.796)

0.669 (0.143, 3.119)

 log [PFOA, ng/mL]

859

0.696 (0.475, 1.019)

0.06

0.715 (0.476, 1.073)

0.11

43

0.352 (0.077, 1.613)

0.18

0.177 (0.023, 1.342)

0.09

PFNA

 Low

266

1.00

0.92

1.00

0.71

19

1.00

0.06

1.00

0.06

 Medium

286

1.016 (0.795, 1.298)

0.978 (0.751, 1.275)

11

1.373 (0.469, 4.017)

1.373 (0.469, 4.017)

 High

277

1.013 (0.791, 1.297)

0.949 (0.723, 1.247)

12

3.117 (0.975, 9.964)

3.117 (0.975, 9.964)

 log [PFNA, ng/mL]

829f

0.941 (0.681, 1.301)

0.71

0.837 (0.587, 1.195)

0.33

42 f

1.360 (0.293, 6.309)

0.69

1.360 (0.293, 6.309)

0.69

PFUnDA

 Low

290

1.00

0.14

1.00

0.08

22

1.00

0.20

1.00

0.04

 Medium

318

1.096 (0.863, 1.391)

1.100 (0.853, 1.419)

17

0.847 (0.341, 2.101)

0.476 (0.157, 1.445)

 High

251

0.828 (0.646, 1.062)

0.784 (0.600, 1.024)

4

0.365 (0.090, 1.469)

0.179 (0.033, 0.970)

 log [PFUnDA, ng/mL]

859

0.838 (0.649, 1.082)

0.18

0.827 (0.628, 1.091)

0.18

43

0.769 (0.251, 2.354)

0.65

0.377 (0.095, 1.494)

0.16

PFHxS

 Low

334

1.00

0.01

1.00

0.05

29

1.00

0.92

1.00

0.18

 Medium

253

0.700 (0.548, 0.893)

0.762 (0.589, 0.986)

10

1.102 (0.381, 3.192)

0.659 (0.184, 2.359)

 High

272

0.733 (0.573, 0.939)

0.769 (0.592, 0.999)

4

0.817 (0.170, 3.936)

0.286 (0.043, 1.892)

 log [PFHxS, ng/mL]

859

0.728 (0.539, 0.985)

0.04

0.759 (0.511, 1.044)

0.09

43

1.095 (0.317, 3.788)

0.89

0.577 (0.143, 2.325)

0.44

PFOS

 Low

293

1.00

0.35

1.00

0.26

25

1.00

0.23

1.00

0.57

 Medium

284

0.903 (0.708, 1.150)

0.843 (0.653, 1.088)

13

1.620 (0.559, 4.691)

1.796 (0.493, 6.546)

 High

282

0.888 (0.694, 1.135)

0.860 (0.661, 1.118)

5

2.345 (0.439, 12.536)

1.208 (0.163, 8.944)

 log [PFOS, ng/mL]

859

0.951 (0.703, 1.288)

0.75

0.885 (0.641, 1.223)

0.46

43

2.006 (0.472, 8.524)

0.35

0.900 (0.166, 4.876)

0.90

MeFOSAA

 Low

329

1.00

0.09

1.00

0.31

20

1.00

0.99

1.00

0.73

 Medium

265

0.829 (0.652, 1.055)

0.865 (0.670, 1.116)

13

0.539 (0.181, 1.609)

0.332 (0.092, 1.200)

 High

265

0.816 (0.642, 1.037)

0.877 (0.677, 1.135)

10

1.033 (0.322, 3.313)

0.876 (0.223, 3.445)

 log [MeFOSAA, ng/mL]

859

0.854 (0.695, 1.049)

0.13

0.929 (0.743, 1.161)

0.52

43

1.567 (0.601, 4.089)

0.36

1.414 (0.465, 4.293)

0.54

  1. OR odds ratio, CI confidence interval
  2. a Based on menopausal status at blood draw; excludes 1 participant for whom menopausal status was unknown
  3. b Crude ORs adjusted for design variables of age at baseline enrollment, race/ethnicity, region of residence
  4. c For the categorical analysis, the p-values represent a test for linear trend with tertiles of PFAS modeled as a 3-level ordinal variable; for the continuous PFAS term, the p-value represents the p-value of the Wald-statistic for the β-coefficient for the PFAS modeled as a continuous term
  5. d For PFOA, PFNA, PFOS, MeFOSAA, covariates included in the fully-adjusted model were:
  6. age at baseline enrollment, race/ethnicity, region of residence, blood draw date, blood draw date2, season of blood draw, total pack-years smoking, BMI, family history of breast cancer, age at first full-term pregnancy, pork consumption. For PFUnDA and PFHxS covariates included in adjusted models were: age at baseline enrollment, race/ethnicity, region of residence, blood draw date, blood draw date2, season of blood draw, total pack-years smoking, family history of breast cancer, age at first full-term pregnancy, pork consumption
  7. e For PFOA covariates included in all fully-adjusted models were: age at baseline enrollment (20–39/40–80+), race/ethnicity (white/non-white), region of residence, blood draw date, blood draw date2, season of blood draw, dietary fat, and total red meat consumption. For PFOS, PFUnDA, PFHxS, and MeFOSAA covariates included in all fully-adjusted models were: age at baseline enrollment (20–39/40–80+), race/ethnicity (white/non-white), region of residence, season of blood draw, and total red meat consumption. For PFNA covariates included in all fully-adjusted models were: age at baseline enrollment (20–39/40–80+), race/ethnicity (white/non-white), and region of residence
  8. f PFNA: Postmenopausal excludes n = 39 with non-reportable serum value, (cases: n = 30; controls: n = 9); Pre-/Peri-menopausal exclude n = 1 case with non-reportable serum value