Tumor and serum levels of per- and polyfluoroalkyl (PFAS) in hepatobiliary and gastrointestinal malignancy

By Kathrine Ann Kelly-Schuette, Larissa Fomum-Mugri, Jessica Walker, Allison Hoppe, Chi-Chi Mbanugo, Nadia Nikroo, Oselenonome Oboh, G Paul Wright, Mathew Chung, and M Mura Assifi
Am J Surg
November 30, 2021
DOI: 10.1016/j.amjsurg.2021.11.014


There has been significant controversy over the carcinogenic potential of per- and polyfluoroalkyl substances (PFAS).

Study Design

A total of 37 serum and tumor samples from patients with hepatobiliary and gastrointestinal malignancy were tested for 24 analytes of PFAS.


At least one PFAS analyte was found in 97% (36/37) of the serum samples and 41% (15/37) of the tumor samples. The serum Perfluorooctanesulfonic acid (PFOS) levels were significantly higher than the national levels (6.77 ng/mL vs. 5.20 ng/mL; p = 0.038). Patients with PFOS in tumor samples had significantly higher levels in serum when compared to tumor samples without PFOS (9.4 ng/mL vs 5.5 ng/mL; p = 0.015).


Patients were found to have significantly higher levels of PFOS when compared to the reported national levels. Additionally, the patients with higher serum levels of PFOS also had tumor positive samples.

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