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

Hurley, Susan; Goldberg, Debbie; Wang, Miaomiao; Park, June-Soo; Petreas, Myrto; Bernstein, Leslie; Anton-Culver, Hoda; Nelson, David O.; Reynolds, Peggy

doi:10.1186/s12940-018-0426-6

Environmental Health

Table 5 Invasive breast cancer risk associated with serum PFAS, by tumor hormone receptor status ^a

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	ER+ or PR+ (n = 1601)					ER- and PR- (n = 965)
	# cases	Crude Odds Ratio (OR) ^b		Adjusted Odds Ratio (OR) ^d		# cases	Crude Odds Ratio (OR) ^b		Adjusted Odds Ratio (OR) ^e
	# cases	OR (95% CI)^b	p-value^c	OR (95% CI) ^d	p-value^c	# cases	OR (95% CI)^b	p-value ^c	OR (95% CI)^e	p-value^c
PFOA
Low	266	1.00	0.50	1.00	0.71	43	1.00	0.38	1.00	0.39
Medium	247	0.923 (0.723, 1.178)		0.918 (0.707, 1.191)		35	0.824 (0.505, 1.346)		0.846 (0.510, 1.403)
High	230	0.917 (0.711, 1.182)		0.952 (0.725, 1.251)		29	0.800 (0.474, 1.348)		0.792 (0.460, 1.365)
log [PFOA, ng/mL]	743	0.781 (0.529, 1.151)	0.21	0.779 (0.513, 1.183)	0.24	107	0.523 (0.246, 1.111)	0.09	0.528 (0.239, 1.165)	0.11
PFNA
Low	233	1.00	0.57	1.00	0.76	33	1.00	0.43	1.00	0.51
Medium	250	1.112 (0.868, 1.426)		1.034 (0.789, 1.354)		34	1.107 (0.659, 1.859)		1.002 (0.583, 1.720)
High	234	1.076 (0.835, 1.387)		0.959 (0.724, 1.270)		36	1.231 (0.734, 2.064)		1.186 (0.690, 2.039)
log [PFNA, ng/mL]	717 ^f	1.096 (0.779, 1.543)	0.60	0.924 (0.634, 1.346)	0.68	103^f	0.783 (0.416, 1.475)	0.45	0.701 (0.357, 1.375)	0.30
PFUnDA
Low	249	1.00	0.38	1.00	0.22	43	1.00	0.03	1.00	0.05
Medium	274	1.116 (0.876, 1.422)		1.125 (0.866, 1.461)		41	0.947 (0.591, 1.518)		1.007 (0.614, 1.651)
High	220	0.889 (0.689, 1.146)		0.838 (0.636, 1.106)		23	0.522 (0.298, 0.912)		0.550 (0.307, 0.985)
log [PFUnDA, ng/mL]	743	0.922 (0.710, 1.196)	0.54	0.892 (0.671, 1.185)	0.43	107	0.661 (0.386, 1.133)	0.13	0.665 (0.375, 1.179)	0.16
PFHxS
Low	287	1.00	0.10	1.00	0.25	54	1.00	0.02	1.00	0.03
Medium	219	0.763 (0.594, 0.980)		0.830 (0.635, 1.084)		28	0.582 (0.352, 0.962)		0.587 (0.350, 0.985)
High	237	0.812 (0.629, 1.048)		0.855 (0.651, 1.122)		25	0.558 (0.326, 0.954)		0.567 (0.326, 0.985)
log [PFHxS, ng/mL]	743	0.874 (0.640, 1.193)	0.40	0.915 (0.655, 1.279)	0.60	107	0.449 (0.250, 0.807)	0.01	0.446 (0.243, 0.821)	0.01
PFOS
Low	250	1.00	0.83	1.00	0.81	47	1.00	0.09	1.00	0.06
Medium	247	1.020 (0.796, 1.305)		0.937 (0.721, 1.218)		32	0.697 (0.427, 1.139)		0.628 (0.378, 1.041)
High	246	1.029 (0.798, 1.327)		0.967 (0.737, 1.270)		28	0.652 (0.387, 1.100)		0.615 (0.357, 1.059)
log [PFOS, ng/mL]	743	1.177 (0.852, 1.626)	0.32	1.054 (0.744, 1.493)	0.77	107	0.645 (0.375, 1.109)	0.11	0.573 (0.323, 1.016)	0.06
MeFOSAA
Low	289	1.00	0.08	1.00	0.23	36	1.00	0.91	1.00	0.89
Medium	228	0.802 (0.628, 1.023)		0.855 (0.660, 1.109)		39	1.106 (0.675, 1.814)		1.124 (0.674, 1.877)
High	226	0.806 (0.630, 1.030)		0.854 (0.655, 1.113)		32	0.968 (0.575, 1.630)		0.960 (0.557, 1.654)
log [MeFOSAA, ng/mL]	743	0.864 (0.699, 1.067)	0.18	0.932 (0.740, 1.173)	0.55	107	0.983 (0.631, 1.531)	0.94	0.996 (0.628, 1.578)	0.98

OR odds ratio, CI confidence interval, ER+ Estrogen receptor positive, PR+ Progesterone receptor positive, ER- Estrogen receptor negative, PR- Progesterone receptor negative
^a Excludes 52 cases with unknown tumor hormone receptor status
^b Models adjusted for age at baseline enrollment, race/ethnicity, region of residence
^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
^d ORs for ER+ or PR+ cases adjusted for: age at baseline enrollment, race/ethnicity, region of residence, date of blood draw, date of blood draw², season of blood draw, total smoking pack-years, BMI, family history of breast cancer, age at first full-term pregnancy, menopausal status at blood draw and pork consumption
^e ORs for ER- and PR- cases adjusted for (except PFNA): age at baseline enrollment, race/ethnicity, region of residence, date of blood draw, date of blood draw², season of blood draw and physical activity. ORs for PFNA adjusted for: age at baseline enrollment, race/ethnicity, region of residence, date of blood draw, date of blood draw² and season of blood draw
^f PFNA: ER+ or PR+ group excludes 26 cases with non-reportable serum values; ER- and PR- group excludes 4 with non-reportable serum values

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ISSN: 1476-069X

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