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Can PFAS Cause Liver Cancer?
Everything You Need to Know

A recent study has found that people with high levels of per- and polyfluoroalkyl substances, also known as PFAS “forever chemicals,” in their blood are more likely to develop hepatocellular carcinoma, the most common form of liver cancer.
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C.L. Mike Schmidt Published by C.L. Mike Schmidt
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Exposure to certain PFAS in the environment has been associated with higher rates of non-viral hepatocellular carcinoma, the most common type of liver cancer, according to an August 2022 study published in JHEP Reports [1].

For the study, researchers at the USC Keck School of Medicine looked at human samples collected from a large epidemiological study called the Multiethnic Cohort Study. The project followed over 200,000 residents of Los Angeles and Hawaii for the development of cancer and other diseases.

The blood and tissue samples allowed the researchers to find 50 individuals who were eventually diagnosed with liver cancer, evaluate the blood samples that were taken prior to their cancer diagnosis and compare these with 50 people from the same study who did not have cancer.

The study's authors were able to identify several types of PFAS in the blood samples that were taken before the participants with liver cancer developed the disease.

The findings indicated that the strongest association was between perfluooctane sulfate, or PFOS, a widely-used substance that belongs to the PFAS family of synthetic chemicals, and liver cancer, and that subjects in the top 10% of PFOS exposure were 4.5 times more likely to develop liver cancer compared to those with the lowest levels of PFOS in their blood.

The researchers were also able to determine the potential mechanisms by which PFOS changed the normal function of the liver. Their evaluation found evidence that PFOS alters the process of glucose metabolism, bile acid metabolism, and the metabolism of branched chain amino acids in the liver.

The alteration of the liver's metabolic processes causes fat to build up in the liver, a condition known as non-alcoholic fatty liver disease (NAFLD). There has been a mysterious increase in NAFLD worldwide over the past several years, which is concerning because people with NAFLD have a higher risk of being subsequently diagnosed with liver cancer. Approximately 30% of all adults in the United States are expected to have NAFLD by 2030, the authors said.

Previous studies had indicated that PFAS exposure increases the risk of liver cancer; however, this study is the first to confirm the link using human samples.

“This builds on the existing research, but takes it one step further,” said Jesse Goodrich, PhD, a postdoctoral scholar in the Department of Population and Public Health Sciences at the Keck School of Medicine. “Liver cancer is one of the most serious endpoints in liver disease and this is the first study in humans to show that PFAS are associated with this disease.”

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