Pre-Diagnostic Serum Concentrations of Per- and Polyfluoroalkyl Substances and Risk of Testicular Germ Cell Tumors Among Active-Duty Servicemen
Abstract
Objectives: The primary objective of our proposed study is to investigate whether elevated blood levels of per- and polyfluoroalkyl substances (PFAS) among active-duty Army, Navy, and Marine Corps Service Members are associated with an increased risk of testicular cancer. Rationale: PFAS are man-made chemicals that have been used over many decades to manufacture firefighting foams, non-stick cookware coating, and other products. PFAS have emerged as important environmental pollutants because of their resistance to degradation (they persist in water and soil for decades or longer) and concerns that they may increase the risk of some cancers (of the kidney and testes in particular). These persistent chemicals are now detectable in the blood of most Americans, mainly due to exposures through contaminated water. Military sites with a history of using PFAS-containing firefighting foams are known to be a major source of PFAS water contamination. However, it is not known whether PFAS exposures among military personnel affect their risk of cancer. To address this question, we recently conducted a study to assess whether Air Force Service Members with higher blood levels of PFAS are at increased risk of testicular cancer, using samples from the Department of Defense Serum Repository (a large biobank of stored blood specimens from military personnel). In an analysis of PFAS measurements in banked samples collected after several years of military service from 186 testicular cancer cases and 186 cancer-free controls, cases were two to three times more likely than controls to have high levels of perfluorooctane sulfonate (PFOS), a type of PFAS. These results are concerning. However, because of the small size of this study, more scientific evidence is needed to confirm this observed PFOS-cancer association. We therefore propose to conduct a larger follow-up study involving banked blood samples of Army, Navy, and Marine Corps Service Members (550 cases, 550 controls) to clarify whether military personnel with higher PFOS exposures are at increased risk of testicular cancer. Ultimate Applications of the Research: The proposed study will provide critical scientific evidence necessary to resolve whether PFOS exposure causes testicular cancer. If our new study confirms this association, these findings could lead to the creation of stricter environmental regulations to reduce exposures among military personnel and the general population. This project is directly relevant to the TERP Program Goal to diagnose the effects of toxic exposures, understand the phenotypic/genotypic and clinical outcomes associated with short-term and long-term exposures and predict disease progression and the Topic Area of Other Military Service-Related Toxic Exposures in General, Including Prophylactic Medications, Pesticides, Organophosphates, Toxic Industrial Chemicals, Materials, Metals and Minerals. In addition, our project has clear relevance to the Focus Area to Evaluate long-term effects of military toxicant exposures in human exposed populations, including Veterans, and the Area of Encouragement of exposure to PFAS relevant to military Service Members. Benefits to Military Service Members and Military Beneficiaries: Our study has important relevance for military Service Members. Military personnel are clearly at risk of exposure to PFAS given the importance of military firefighting training sites as a major source of water contamination; in our preliminary study, we found notably higher serum PFAS levels among military firefighters and Service Members who previously served at bases known to have high PFAS levels in drinking water. Testicular cancer also has important military relevance, as it is the most common cancer diagnosed among active-duty personnel. Although survival from testicular cancer is high, survivors are at increased risk of many treatment-related complications including infertility, depression, cardiovascular d
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310968
Entities
People
- Mark P. Purdue
Organizations
- National Cancer Institute
- United States Army