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Table 2 Odds ratios (ORs) and 95% confidence intervals (CIs) for breast cancer according to plasma PFAS concentrations

From: Plasma perfluoroalkyl substances and breast cancer risk in Brazilian women: a case–control study

PFASa

Range

 

No. of

No. of

 

Crude OR (95% CI)b

 

Adjusted OR (95% CI)

[ng/mL]

 

cases

controls

   

Model 1c

Model 2d

Total PFHxS

         
 

< 80%ile

< 0.83

 

396

375

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

≥ 80%ile

0.83–5.74

 

75

96

 

0.60 (0.38, 0.93)

 

0.55 (0.31, 0.98)

0.49 (0.26, 0.92)

 

P

     

0.023

 

0.044

0.026

Total PFOS

         
 

Quartile 1

< 6.39

 

134

117

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 2

6.39–9.01

 

124

118

 

0.89 (0.62, 1.27)

 

1.03 (0.64, 1.66)

1.00 (0.61, 1.64)

 

Quartile 3

9.03–12.19

 

107

118

 

0.74 (0.50, 1.10)

 

0.97 (0.58, 1.62)

0.90 (0.52, 1.56)

 

Quartile 4

12.21–90.57

 

106

118

 

0.74 (0.50, 1.09)

 

1.02 (0.61, 1.71)

0.91 (0.50, 1.63)

 

P for trend

     

0.13

 

0.95

0.72

Total PFOA

         
 

Quartile 1

< 1.22

 

134

116

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 2

1.22–1.60

 

115

119

 

0.82 (0.57, 1.18)

 

0.89 (0.55, 1.43)

0.86 (0.52, 1.42)

 

Quartile 3

1.61–2.11

 

117

118

 

0.83 (0.57, 1.21)

 

0.95 (0.58, 1.56)

0.86 (0.51, 1.45)

 

Quartile 4

2.12–73.04

 

105

118

 

0.74 (0.51, 1.09)

 

0.85 (0.51, 1.42)

0.70 (0.39, 1.27)

 

P for trend

     

0.18

 

0.60

0.26

n-PFHpS

         
 

< Median

< 0.08

 

236

233

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 3

0.08–0.18

 

111

120

 

0.90 (0.63, 1.29)

 

1.12 (0.70, 1.81)

1.28 (0.78, 2.10)

 

Quartile 4

0.19–1.65

 

124

118

 

1.04 (0.72, 1.49)

 

1.58 (0.96, 2.60)

2.00 (1.15, 3.48)

 

P for trend

     

0.86

 

0.077

0.015

n-PFOS

         
 

Quartile 1

< 3.68

 

147

116

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 2

3.68–5.21

 

128

119

 

0.82 (0.57, 1.19)

 

0.93 (0.58, 1.49)

0.86 (0.53, 1.40)

 

Quartile 3

5.22–7.16

 

106

117

 

0.65 (0.44, 0.96)

 

0.80 (0.49, 1.31)

0.75 (0.44, 1.29)

 

Quartile 4

7.30–60.75

 

90

119

 

0.56 (0.38, 0.82)

 

0.85 (0.51, 1.40)

0.71 (0.39, 1.28)

 

P for trend

     

0.003

 

0.50

0.27

3 m-PFOS

         
 

< Median

< 0.39

 

224

235

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 3

0.39–0.55

 

126

115

 

1.15 (0.84, 1.58)

 

1.46 (0.95, 2.25)

1.71 (1.06, 2.77)

 

Quartile 4

0.56–11.77

 

121

121

 

1.06 (0.76, 1.49)

 

1.36 (0.85, 2.17)

2.12 (1.13, 3.96)

 

P for trend

     

0.70

 

0.20

0.022

4 m-PFOS

         
 

< Median

< 0.65

 

240

227

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 3

0.65–0.91

 

112

125

 

0.83 (0.59, 1.16)

 

0.85 (0.55, 1.32)

0.90 (0.56, 1.46)

 

Quartile 4

0.92–15.30

 

119

119

 

0.93 (0.66, 1.32)

 

1.00 (0.63, 1.59)

1.18 (0.63, 2.22)

 

P for trend

     

0.63

 

0.95

0.64

5 m-PFOS

         
 

Quartile 1

< 0.70

 

125

116

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 2

0.70–1.01

 

120

114

 

0.95 (0.65, 1.37)

 

1.18 (0.72, 1.94)

1.15 (0.68, 1.92)

 

Quartile 3

1.02–1.43

 

121

121

 

0.90 (0.61, 1.33)

 

0.86 (0.50, 1.46)

0.79 (0.44, 1.40)

 

Quartile 4

1.44–25.85

 

105

120

 

0.78 (0.53, 1.17)

 

0.88 (0.51, 1.51)

0.74 (0.40, 1.39)

 

P for trend

     

0.20

 

0.36

0.16

6 m-PFOS

         
 

Quartile 1

< 0.82

 

119

117

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 2

0.82–1.20

 

124

118

 

1.03 (0.71, 1.50)

 

1.13 (0.69, 1.85)

1.11 (0.66, 1.87)

 

Quartile 3

1.21–1.68

 

115

116

 

0.97 (0.66, 1.42)

 

1.04 (0.63, 1.74)

1.02 (0.59, 1.77)

 

Quartile 4

1.69–18.75

 

113

120

 

0.92 (0.63, 1.35)

 

0.99 (0.59, 1.66)

0.97 (0.53, 1.78)

 

P for trend

     

0.58

 

0.83

0.79

3,5 dm-PFOS

         
 

< Median

< 0.06

 

205

213

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 3

0.06–0.12

 

148

136

 

1.16 (0.83, 1.61)

 

1.36 (0.86, 2.15)

1.37 (0.86, 2.19)

 

Quartile 4

0.13–5.78

 

118

122

 

1.02 (0.72, 1.44)

 

1.14 (0.72, 1.81)

1.26 (0.77, 2.07)

 

P for trend

     

0.98

 

0.70

0.42

n-PFOA + 4 m-PFOA

        
 

Quartile 1

< 0.89

 

135

117

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 2

0.89–1.23

 

115

118

 

0.84 (0.59, 1.20)

 

0.92 (0.58, 1.46)

0.88 (0.54, 1.44)

 

Quartile 3

1.24–1.74

 

114

117

 

0.83 (0.57, 1.20)

 

0.97 (0.59, 1.59)

0.86 (0.51, 1.47)

 

Quartile 4

1.76–72.80

 

107

119

 

0.77 (0.53, 1.11)

 

0.92 (0.55, 1.52)

0.76 (0.43, 1.37)

 

P for trend

     

0.19

 

0.79

0.39

n-PFNA

         
 

< Median

< 0.19

 

241

235

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 3

0.19–0.27

 

115

111

 

0.97 (0.68, 1.39)

 

1.45 (0.90, 2.33)

1.65 (0.99, 2.77)

 

Quartile 4

0.28–3.89

 

115

125

 

0.80 (0.51, 1.25)

 

1.68 (0.89, 3.15)

2.19 (1.05, 4.56)

 

P for trend

     

0.35

 

0.094

0.033

n-PFDA

         
 

< Median

< 0.09

 

244

224

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 3

0.09–0.13

 

131

126

 

0.92 (0.67, 1.25)

 

1.00 (0.66, 1.51)

1.00 (0.65, 1.55)

 

Quartile 4

0.14–2.26

 

96

121

 

0.64 (0.43, 0.94)

 

0.87 (0.51, 1.48)

0.72 (0.38, 1.34)

 

P for trend

     

0.030

 

0.64

0.37

n-PFDoDA

         
 

< Median

< 0.05

 

206

212

 

1.00 (Reference)

 

1.00 (Reference)

1.00 (Reference)

 

Quartile 3

0.05–0.07

 

117

120

 

1.03 (0.72, 1.46)

 

1.23 (0.77, 1.97)

1.31 (0.81, 2.11)

 

Quartile 4

0.08–3.03

 

148

139

 

1.15 (0.79, 1.68)

 

1.31 (0.80, 2.15)

1.35 (0.81, 2.25)

 

P for trend

     

0.46

 

0.29

0.26

  1. For total PFHxS, women were dichotomized by 80%iles because of low detection frequency
  2. a Medians, quartiles, and 80%iles are based on the distribution of plasma PFAS concentrations among controls
  3. b Analyses were performed using conditional logistic regression models of matched case–control sets
  4. c Conditional logistic regression models adjusted for body mass index, height, menopausal status and age at menopause, age at menarche, age at first childbirth, smoking status, strenuous physical activity in the past 5 years, moderate physical activity in the past 5 years, family history of breast cancer, breastfeeding duration, number of births, alcohol intake, education level, calendar year of blood sampling, isoflavone intake, and fish and shellfish intake
  5. d Additionally adjusted for all other PFAS congeners (natural log-transformed concentration) with a detection frequency of 50% or higher (Table S1), excluding combinations of PFAS congeners with a Spearman rank correlation coefficient of 0.70 or higher to avoid multicollinearity. The branched PFOS isomers (excluding 3,5 dm-PFOS) were not used as covariates for adjustment because they were highly correlated with each other (Table S2)
  6. Bold font indicates a statistically significant association
  7. In the analyses of Models 1 and 2, we excluded 12 pairs that included women with extremely low (< 500 kcal) or high (≥ 4000 kcal) daily total energy intake. Owing to missing covariates, 447 cases and 443 controls were finally used in Model 1 and 2 analyses
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