Associations between per-and polyfluoroalkyl substances (PFAS) and county-level cancer incidence between 2016 and 2021 and incident cancer burden attributable to PFAS in drinking water in the United States

Abstract

The ecological study examined the associations between PFAS in drinking water measured in two waves (2013-2015 and 2023-2024) and cancer incidence between 2016 and 2021. We found that PFAS in drinking water was associated with cancers in the organ system including the oral cavity/pharynx, lung, digestive system, brain, urinary system, soft tissue, and thyroid. Some cancers have not been widely studied for their associations with PFAS. We also observed sex differences in the associations between PFAS and cancer risks. This is the first ecological study that examined PFAS exposure in drinking water and various cancer risks.