全氟烷基物质和多氟烷基物质 (PFAS) 是环境持久性、潜在致癌化学物质。先前调查 PFAS 暴露与前列腺癌的研究得出了不同的结果。我们的目的是调查一大群美国男性的 PFAS 暴露与前列腺癌发病之间的关联，包括总体情况以及选定的人口、生活方式和医疗相关特征。我们在癌症预防研究 II LifeLink 队列参与者中进行了一项病例队列研究在基线（1998-2001）时，收集了血清样本且之前没有癌症诊断。该研究包括随访期间（基线至 2015 年 6 月 30 日）期间诊断出患有前列腺癌的所有男性 (n=1610) 以及由 500 名男性组成的随机分组。测量储存的血清样本中的 PFAS 浓度[全氟己烷磺酸 (PFHxS)、全氟辛烷磺酸 (PFOS)、全氟壬酸 (PFNA) 和全氟辛酸 (PFOA)]。我们使用多变量 Cox 比例风险模型来估计 PFAS 浓度与前列腺癌之间的总体关联和选定的特征（年级、分期、家族史、年龄、教育程度、吸烟状况和饮酒量）。男性前列腺癌的风险略高PFHxS 的浓度处于最高 (Q4) 与最低四分位数 (Q1) [风险比 (HR) (95% CI)：1.18 (0.88-1.59)] 和 PFOS [HR (95% CI)：1.18 (0.89-1.58) )]，但不适用于 PFNA 或 PFOA。然而，我们观察到年龄、前列腺癌家族史 (PFHxS)、饮酒量 (PFHxS) 和教育程度 (PFNA) 之间存在异质关联。例如，在血清采集时年龄 <70 岁的男性中没有观察到有意义的关联，但在年龄 ≥70 岁的男性中，比较 Q4 和 Q1 的 HR (95% CI) 为 PFHxS 1.54 (1.02-2.31) 和 PFOS 1.62 (1.08-2.31)。 2.44）。未观察到肿瘤分级或分期之间有意义的关联异质性。我们的研究结果并不能明确支持所考虑的 PFAS 与前列腺癌之间的关联。然而，在某些亚组中观察到的正相关性以及在 PFHxS 中观察到的持续正相关性值得进一步调查。版权所有 © 2024。由 Elsevier Inc. 出版。

Per- and polyfluoroalkyl substances (PFAS) are environmentally persistent, potentially carcinogenic chemicals. Previous studies investigating PFAS exposure and prostate cancer yielded mixed findings. We aimed to investigate associations between PFAS exposure and incident prostate cancer in a large cohort of U.S. men, overall and by selected demographic, lifestyle, and medical-related characteristics.We conducted a case-cohort study among Cancer Prevention Study-II LifeLink Cohort participants who, at baseline (1998-2001), had serum specimens collected and no prior cancer diagnosis. The study included all men diagnosed with prostate cancer (n=1610) during follow-up (baseline-June 30, 2015) and a random sub-cohort of 500 men. PFAS concentrations [perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorooctanoic acid (PFOA)] were measured in stored serum specimens. We used multivariable Cox proportional hazards models to estimate associations between PFAS concentrations and prostate cancer, overall and by selected characteristics (grade, stage, family history, age, education, smoking status, and alcohol consumption).Prostate cancer hazards were slightly higher among men with concentrations in the highest (Q4) vs lowest quartile (Q1) for PFHxS [hazard ratio (HR) (95% CI): 1.18 (0.88-1.59)] and PFOS [HR (95% CI): 1.18 (0.89-1.58)], but not for PFNA or PFOA. However, we observed heterogeneous associations by age, family history of prostate cancer (PFHxS), alcohol consumption (PFHxS), and education (PFNA). For example, no meaningful associations were observed among men aged <70 years at serum collection, but among men aged ≥70 years, HRs (95% CIs) comparing Q4 to Q1 were PFHxS 1.54 (1.02-2.31) and PFOS 1.62 (1.08-2.44). No meaningful heterogeneity in associations were observed by tumor grade or stage.Our findings do not clearly support an association between the PFAS considered and prostate cancer. However, positive associations observed in some subgroups, and consistently positive associations observed for PFHxS warrant further investigation.Copyright © 2024. Published by Elsevier Inc.