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Seventeen studies were included, and pooled results found no clear associations across cancers. Stratified analyses showed no links for colorectal and pancreatic cancers, no dose-response trends, and possible publication bias for gastric cancer. Overall evidence was inconclusive, requiring more rigorous research with precise PFAS quantification and improved confounder control.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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is the main goal of this systematic review and meta-analysis?","Question",{"text":63,"@type":64},"To investigate the association between PFAS exposure and the risks of gastrointestinal cancers, including esophageal, gastric, colorectal, and pancreatic cancer.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which sources of studies were searched for the analysis?",{"text":68,"@type":64},"Literature was searched from International Agency for Research on Cancer Monographs, Agency for Toxic Substances and Disease Registry documents, and PubMed up to January 2024.",{"name":70,"@type":61,"acceptedAnswer":71},"What did the pooled results show about PFAS and GI cancer risk?",{"text":72,"@type":64},"The study suggested no association between PFAS exposure and esophageal, gastric, colorectal, or pancreatic cancer, and the overall evidence was considered inconclusive.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},331772,1790155146,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,111,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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 \nPer-and poly-fluoroalkyl substances exposure and risk of gastrointestinal cancers: a systematic review and meta-analysis  \nSirui Zhanga,*, Elizabeth Maria Kappila,*, Tongzhang Zhenga, Paolo Boffettab,c,d and Monireh Sadat Seyyedsalehib  \nBackground Per-and poly-fluoroalkyl substances (PFASs) are a group of synthetic chemicals used since the 1940s in industrial and consumer applications. These substances are known or suspected to cause cancer, particularly kidney and testicular cancer. However, their association with other types of cancer is not well understood. This review aims to investigate the link between PFAS exposure and the risks of other cancers, including gastrointestinal cancers such as esophageal, gastric, colorectal, and pancreatic cancer.  \nMethods We conducted a systematic review of literature from the International Agency for Research on Cancer Monographs, Agency for Toxic Substances and Disease Registry documents, and PubMed (up to January 2024) focusing on the association between PFAS exposure and gastrointestinal cancers. Four independent reviewers screened the studies, extracted the information, and evaluated the quality of the studies using a modified Newcastle-Ottawa Scale. Meta-analyses were performed with random-effects models, including stratified analyses and dose-response assessments.  \nResults The meta-analysis included 17 studies. The summary relative risks (RR) of esophageal cancer for perfluorooctanoic acid (PFOA) exposure was 0.75 (95% confidence interval [CI], 0.35–1.60; n = 2), and for perfluorooctane sulfonic acid (PFOS) was 1.76 (95% CI, 0.32–9.68; n = 1). The RR for gastric cancer and PFOA was 0.59 (95% CI, 0.28–1. 21; n = 2) and PFAS was 0.96 (95% CI, 0.83–1. 12; n = 2). The RR for colorectal cancer and PFOA was 0.83 (95% CI, 0.65–1.06; n = 6) and PFOS was 0.71 (95% CI, 0.22–2. 27; n = 4). The RR for pancreatic cancer was 1.02 (95% CI, 0.90–1. 15; n = 9) and PFOS  \nBackground  \nGastrointestinal (GI) cancers account for 1 in 4 cancer cases and 1 in 3 cancer deaths globally (Arnold et al., 2020), especially esophageal, gastric, colorectal, and pancreatic  \nSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website ([www.eurjcancerprev.com](www.eurjcancerprev.com)).  \nThis is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nwas 0.92 (95% CI, 0.76–1. 11; n = 2). Stratified analyses by geographical region, study design, quality score, year of publication, gender, and outcome revealed no associations for colorectal and pancreatic cancers. No dose-response trends were identified. Publication bias was suggested for gastric cancer.  \nConclusion Our study suggested no association between PFAS exposure and esophageal, gastric, colorectal, or pancreatic cancer. More rigorous research is needed to investigate this relationship in different settings, with precise PFAS quantification, a wider range of compounds, larger sample sizes for specific cancers, and better control for potential confounders. Our meta-analysis suggests inconclusive evidence, highlighting the need for further research. European Journal of Cancer Prevention 34: 445–455 Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.  \nEuropean Journal of Cancer Prevention 2025, 34:445–455  \nKeywords: colorectal, environmental exposure, esophagus, gastric, gastrointestinal malignancy, occupational exposure, pancreas, perfluorooctane sulfonic acid, perfluorooctanoic acid  \na Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA, bDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy, cStony Brook Cancer Center","cbCaijV0bZAaIiTT","https://ap.wps.com/l/cbCaijV0bZAaIiTT","pdf",1785293,11,"English","# Background\n# Methods\n# Results\n## Cancer-specific risk estimates\n# Conclusion","[{\"question\":\"What is the main goal of this systematic review and meta-analysis?\",\"answer\":\"To investigate the association between PFAS exposure and the risks of gastrointestinal cancers, including esophageal, gastric, colorectal, and pancreatic cancer.\"},{\"question\":\"Which sources of studies were searched for the analysis?\",\"answer\":\"Literature was searched from International Agency for Research on Cancer Monographs, Agency for Toxic Substances and Disease Registry documents, and PubMed up to January 2024.\"},{\"question\":\"What did the pooled results show about PFAS and GI cancer risk?\",\"answer\":\"The study suggested no association between PFAS exposure and esophageal, gastric, colorectal, or pancreatic cancer, and the overall evidence was considered inconclusive.\"}]","Per-and poly-fluoroalkyl substances exposure and risk of gastrointestinal cancers: a systematic review and meta-analysis | PDF",1789995038,28]