• In 2020, about 8.8 million women globally had cancer.
• Researchers continue to investigate potential risk factors for a woman developing cancer, including exposure to “forever chemicals.”
• Researchers recently discovered that women who developed breast, ovarian, skin, and uterine cancers had significantly higher levels of these types of chemicals in their bodies.

Of the 8.8 million women who had cancer worldwide in 2020, 2.3 million women were diagnosed with breast cancer, making it the most prevalent cancer in the world.

Colorectal, lung, cervical, ovarian, uterine (endometrial), and skin cancers are also common in women.

While it is generally not known what exactly causes cancer, past studies show a woman’s risk for cancer depends on a variety of factors. These could include genetics, smoking, obesity, hormones, and environmental risk factors like air pollution and exposure to certain chemicals called “forever chemicals.”

Now, researchers from the University of Southern California have discovered women who developed breast, ovarian, skin, and uterine cancers had significantly higher levels of these types of chemicals in their bodies.

This study was recently published in the Journal of Exposure Science and Environmental Epidemiology.

Forever chemicals and cancer risk

For this study, researchers focused on studying the levels of chemicals like per- and polyfluoroalkyl substances (PFAS) and phenols like bisphenol A (BPA) in women with certain cancers.

BPA is a chemical used primarily to make polycarbonate plastics used in water bottles, shatterproof windows, eyewear, and coatings. Past studies state BPA is a possible human carcinogen with potential negative impacts on a person’s health.

“We studied these chemicals because we know there is widespread human exposure,” Dr. Max T. Aung, assistant professor of population and public health sciences at the Keck School of Medicine at the University of Southern California and senior author of this study, told Medical News Today.

“Therefore, we need to better understand the extent to which these chemicals may be risk factors for diseases like cancer. By doing so, we can help inform prevention and intervention efforts,” he said.

“Increasing animal in vitro evidence indicates that PFAS and phenols can affect hormone disruption, inflammation, and metabolism. All of these biological effects may influence cancer risk.”
— Dr. Max T. Aung

Doubled cancer odds with PFAS exposure

Dr. Aung and his team analyzed data from blood and urine samples of men and women in the National Health and Nutrition Examination Survey (NHANES). They used two datasets. The first looked at concentrations of PFAS in over 16,000 individuals, while the second examined levels of phenols/parabens in over 10,000 individuals.

They used extracted concentrations of seven of PFAS and 12 types of phenols/parabens, plus self-reported diagnoses of thyroid, breast, ovarian, uterine, and prostate cancers and melanoma.

Upon analysis, scientists found women with high exposure to PFDE — a type of PFAS — had twice the odds of a melanoma diagnosis. And women with increased exposure to two other PFAS compounds — PFNA and PFUA — had almost double the likelihood of having a diagnosis of melanoma.

Researchers also discovered a link between PFNA and a prior diagnosis of uterine cancer.

And women with high exposure to phenols like BPA increased their chances of receiving an ovarian cancer diagnosis.

“Based on previous experimental studies, we hypothesized that PFAS would be associated with some cancers. These findings can strengthen clinicians’ knowledge of environmental risk factors for cancer when they communicate with patients.”
— Dr. Max T. Aung

What are ‘forever chemicals’?

The term “forever chemicals” refers to manmade chemicals used in a variety of industries that do not break down naturally in the environment or in our bodies.

These chemicals called PFAS can sometimes be leached into the air, water, and soil through waste from industrial manufacturing.

Because PFAS are used for making products water, grease, and stain-resistant, they can also be found in a variety of everyday products, including:

• nonstick cookware
• pizza boxes and other food packaging
• water-resistant clothing such as raincoats
• umbrellas
• camping tents
• stain-resistant coatings on carpeting and upholstery
• cleaning products

Humans are exposed to PFAS by:

• breathing in contaminated air or dust
• eating food grown in contaminated soil or served in PFAS-including packaging
• cooking food on cookware using PFAS
• eating fish with high levels of PFAS
• drinking PFAS-contaminated water
• using consumer products that have PFAS in or on them

In addition to cancer, previous research shows exposure to PFAS may increase a person’s risk for high cholesterol, cardiovascular disease, thyroid disease, asthma, and decreased fertility.

Racial differences in forever chemical exposure

The study also observed some racial differences when it came to “forever chemical” exposure and cancer risk.

For instance, associations between various PFAS and ovarian and uterine cancers were observed only among white women. However, associations between a PFAS called MPAH and a phenol called BPF and breast cancer were observed only among non-white women.

“There is some evidence indicating that exposure to PFAS and phenols may be higher in certain racial groups based on sources of exposure such as food packaging, personal care products, and proximity to contaminated drinking water,” Dr. Aung said.

“Future directions in my research will involve deepening knowledge of biological mechanisms linking PFAS and phenols to cancer outcomes. We will be exploring various biomarkers in future studies to better understand mechanisms of exposure to these exposures,” he added.

No causal relationship between BPA, PFAS, and cancer

Medical News Today also spoke with Dr. Jack Jacoub, a board-certified medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, CA, about this study.

He stated this study does have limitations as it is not able to establish a causal relationship with PFAS and BPA chemicals levels in cancer.

“There is perhaps a relationship because there’s a higher frequency of a certain cancer correlating with a certain level of these chemicals, but because there’s a higher frequency of the cancers, this is a statistical scenario or an issue in that those higher frequency cancers, we need to have more information on those individuals and their cancer.”
— Dr. Jack Jacoub

For readers who may be worried about “forever chemicals” and increased cancer risk, Dr. Jacoub suggested eliminating them from their lifestyle would be the way to go as we wait for more data.

“It’s reasonable to remove some of the things that are everyday kinds of things (where they) might exist,” he continued.

“Plastics — we’re using paper bags, okay, that’s great for the environment and also maybe great for you. All those small little details in someone who may have a preexisting risk of cancer because of family history, because of exposure to radiation, something in their make-up suggests they might have a higher risk of cancer, if you really wanted to be as proactive as humanly possible, understanding the areas where those chemicals exist and eliminating them from your environment would be a positive,” he added.

Tips for lowering exposure to forever chemicals

“These results show strong associations between certain cancers and exposures to phenols, parabens, and PFAS,” Dr. Ariana Spentzos, science and policy associate for the Green Science Policy Institute, told Medical News Today.

“Therefore, doctors should educate their patients about the importance of minimizing harmful chemical exposure due to their potential to cause cancer and other health issues,” she said.

For readers looking to decrease their exposure to PFAS and BPA chemicals, Dr. Spentzos suggested:

• Use a granular activated carbon or reverse osmosis water filter for drinking water.
• Do not use personal care products/cosmetics that include PFAS.
• Beware of PFAS in menstrual products.
• Limit fish consumption, especially freshwater fish.
• Limit consumption of fast food/overly processed food.
• Prioritize plant-based food over animal-based foods.
• Do not purchase textile products that are marketed as stain-resistant or water-resistant unless you are sure that they are made without PFAS.
• Do not heat foods in plastic containers.
• Buy products that are PFAS-free.

“If (a) doctor and patient think that the patient may be at risk of high exposure to PFAS, then they (should) consider testing the patient for PFAS,” Dr. Spentzos added.

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