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Background: Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are persistent synthetic compounds that may have associated health risks.

Purpose: To explore the association between four common detectable serum PFASs perfluorooctanoic acid (PFOA), perfluorooctyl sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) and cancer risk in United States (U.S.) adults.

Methods: Data from 4,497 participants from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. Gender stratified adjusted logistic regression analysis was conducted to determine association between serum PFASs tertiles and risk of cancer.

Results: Median (IQR) PFASs were significantly higher in men compared to women, and among individual with cancer than healthy participants (p < .05 for both). In unadjusted analysis, a significantly high risk of cancer was noted in males in high PFOS tertile compared to low group the unadjusted odds of cancer in males were 115% (OR 2.15; 95% CI 1.502, 3.078; p < .001) elevated in high PFOS tertile compared to referent. In unadjusted analysis, a significantly elevated risk of cancer was noted in females for PFOA, PFOS, PFHxS high tertile as well as medium tertile compared to low group. The unadjusted odds of cancer in females were 132%, p < .001, 157%, p < .001, 235%; p < .001 elevated in women in high PFOA, PFOS, PFHxS tertile, respectively compared to low group. In adjusted models no significant association between PFAS serum levels and cancer was observed in men or women.

Conclusion: In U.S. adults, serum PFASs levels were not significantly associated with cancer.

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