PFOA and testis cancer in the Veneto Region (Italy) - Comment Open Access - Abstract and public health surveillance recommendations

Sep 22, 2026

The largest documented episode of PFOA contamination affecting humans occurred in Italy’s Veneto Region, involving approximately 150,000 residents as of 1 January 2020. In this mostly flat agricultural plain, a cluster of testicular cancers was also observed, and preliminary findings are presented. The article highlights the most relevant, recent recommendations for health surveillance of exposed individuals, supported by evaluation approaches using cancer registry and hospital records.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages3

Reading Time8 min

AccessFree to download

Abstract

Background

Testicular cancer evaluations in the Veneto Region

Data sources and case-finding approach

Subarea analysis and incidence results

Saugo et al. Environmental Health (2024) 23:33 [https://doi.org/10.1186/s12940-024-01064-4](https://doi.org/10.1186/s12940-024-01064-4) Environmental Health COMMENT Open Access PFOA and testis cancer in the Veneto Region (Italy) Mario Saugo 1*, Enrico Ioverno 1, Armando Olivieri 1, Francesco Bertola 1, Angela Pasinato 1 and Alan Ducatman2 Abstract The largest documented episode of human contamination by PFOA in the world (approximately 150,000 actual residents on 1 January 2020) has occurred in Italy’s Veneto Region. In this large, mostly flat plain area, a cluster of testicular cancers has also been observed. Preliminary data are reported, and the most relevant and recent recommendations regarding the health surveillance of exposed individuals are emphasized. Keywords PFOA (perfluorooctanoic acid), PFAS (per-and polyfluoroalkyl substances), Testicular Cancer, Public Health Surveillance Background The International Agency for Research on Cancer (IARC) has recently drawn public attention to PFOA (Class I) and PFOS (Class IIb) as carcinogens, with the strongest evidence in humans for kidney cancer followed by testicular cancer. Among new evidence, the IARC Working Group took into consideration an ecological analysis of rates of orchiectomy, an indicator of testicular cancer, conducted in the Veneto Region (Italy) [1]. English-speaking readers may appreciate some additional details, as the original report is in Italian [2]. Testicular cancer evaluations in the Veneto Region Extensively documented human exposures to high dose PFOA are from communities impacted by industrial pollution, such as the well-known case in the mid-Ohio Valley, United States, in the Veneto Region, Italy, while another relevant episode of PFAS drinking water contamination featured a firefighting foam source, and exposure *Correspondence: Mario Saugo[saughi@ymail.com](saughi@ymail.com) 1College of Physicians of the Province of Vicenza, Vicenza, Italy 2West Virginia University, Morgantown, WV, US to perfluorooctanesulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS) in Ronneby, Sweden [3–5]. Appreciation for the contamination in the Veneto Region emerged in 2013 and represents the widest episode of PFOA human exposure described worldwide. At the time the above mentioned Venetian report was drafted in 2016 [2], the available data from the Veneto Region Cancer Registry concerning the impacted area covered only the period 2010–2013 [6]. Case-finding was therefore extended, abstracting orchiectomies for testicular cancer in males aged 15–54 in the Veneto Region from 1997 to 2014 from the archives of Hospital Discharges (ICD-9-CM 186 code for diagnosis and 62.3– 62.4 codes for surgical procedures). When considering data from a non-impacted area of the Veneto Region with IARC-certified cancer registration, this approach showed high sensitivity (92%, 95% CI 87%-95%) and positive predictive value (90%, 95%CI 85-93%) for the diagnosis. Each case was assigned the date of admission and the municipality of residence recorded at hospital admission. Expected cases were calculated using indirect internal standardization: five-year age group-specific cumulative incidence rates in the Veneto Region were applied to each quinquennial strata of the average population residing in each of the 21 municipalities that constituted the © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons

FAQs

What contamination event is described in the paper, and where did it occur?

The paper describes the largest documented human contamination episode by PFOA, occurring in Italy’s Veneto Region, affecting about 150,000 residents as of 1 January 2020.

What cancer pattern was observed in the Veneto Region?

Along with the PFOA contamination, a cluster of testicular cancers was observed in the region, and the paper reports preliminary data and incidence comparisons.

How are exposed individuals and impacted areas assessed for health surveillance?

The article emphasizes health surveillance recommendations and outlines how cases were identified using hospital discharge records and cancer registry data, including analysis by impacted subareas and municipalities.

Sep 22, 2026

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