Evidence map›Paper›PMID 40939531›Full record

ArticleEnvironment international2025

A scoping review on per- and poly-fluoroalkyl substances (PFAS) and colorectal cancer: Evidence from in vitro, animal, and epidemiological studies.

Devendra Paudel, Haonan Li, Elizabeth A Holzhausen, Nathan Young, Elizabeth A Platz, Douglas I Walker, Donghai Liang, Max Aung, Jesse A Goodrich, Veronica Wendy Setiawan and 5 more

Abstract readScoping Review
In one paragraph

Article in Environment international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Size-Resolved PMToxics · 2026
    Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Devendra PaudelDepartment of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Haonan LiDepartment of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Elizabeth A HolzhausenDepartment of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Nathan YoungDepartment of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Elizabeth A PlatzDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Douglas I WalkerGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Donghai LiangGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Max AungDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Jesse A GoodrichDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Veronica Wendy SetiawanDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Loic Le MarchandEpidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.
Brian Z HuangDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
David V ContiDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Lida ChatziDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Tanya L AldereteDepartment of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: taldere1@jhu.edu.

Funding

Translational Research Support CoreP30ES007048 · NIEHS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI ROB S MCCONNELL · 1996 to 2026
$46.4M
Understanding Population Differences in Cancer: The MEC StudyU01CA164973 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI HAIMAN, CHRISTOPHER ALAN, LE MARCHAND, LOIC · 2015 to 2025
$37.4M
Traning Program in Environmental Health SciencesT32ES007141 · NIEHS · JOHNS HOPKINS UNIVERSITY · PI Marsha Wills-Karp · 1985 to 2026
$22.2M
Southern Environmental Health StudyUH3CA265846 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Martha J. Shrubsole, Wei Zheng · 2023 to 2026
$9.8M
Southern California Superfund Research and Training Program for PFAS Assessment, Remediation, and Prevention (ShARP)P42ES036506 · NIEHS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Jane Karen Steinberg · 2025 to 2026
$8.2M
Pilot Project ProgramP30ES032756 · NIEHS · JOHNS HOPKINS UNIVERSITY · PI Christopher D Heaney · 2022 to 2026
$6.0M
NEXUS: Network for Exposomics in the U.S.U24ES036819 · NIEHS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Rima Habre, GARY W MILLER · 2024 to 2026
$4.6M
Effects of DDE exposure on adipose tissue function, weight loss and metabolic improvement after bariatric surgery: A new paradigm for study of lipophilic chemicalsR01ES030364 · NIEHS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI CHATZI, VAIA LIDA · 2020 to 2024
$3.2M
Environmental Chemical Exposures and Longitudinal Changes of Glucose Metabolism, Insulin Sensitivity and B Cell Function in YouthR01ES029944 · NIEHS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI CHATZI, VAIA LIDA · 2019 to 2023
$3.1M
Perfluoroalkyl Substances and the Gut Microbiome and Fecal Metabolome: Implications for Obesity Risk in Hispanic ChildrenR01ES035035 · NIEHS · UNIVERSITY OF COLORADO · PI Tanya Lynn Alderete · 2023 to 2026
$2.6M
Longitudinal integration of environmental exposures, omics, and childhood NAFLD (LEON) StudyU01HG013288 · NHGRI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI AUNG, TUN (MAX) M, CHATZI, VAIA LIDA · 2023 to 2025
$2.4M
A nested case-control study of perfluoroalkyl and polyfluoroalkyl substances (PFAS) and breast cancer risk in the Multiethnic CohortR01CA279668 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Eunjung Lee · 2023 to 2026
$2.3M
NCI NIH HHS R00 CA256525NCI NIH HHS R01 CA279668NCI NIH HHS U01 CA164973NCI NIH HHS UH3 CA265846NHGRI NIH HHS U01 HG013288NIDDK NIH HHS R01 DK140831NIEHS NIH HHS K01 ES036193NIEHS NIH HHS P30 ES007048NIEHS NIH HHS P30 ES032756NIEHS NIH HHS P42 ES036506NIEHS NIH HHS R01 ES029944NIEHS NIH HHS R01 ES030364NIEHS NIH HHS R01 ES030691NIEHS NIH HHS R01 ES032831NIEHS NIH HHS R01 ES035035NIEHS NIH HHS R01 ES035056NIEHS NIH HHS R01 ES035738NIEHS NIH HHS R01 ES036253NIEHS NIH HHS T32 ES007141NIEHS NIH HHS U24 ES036819NIMHD NIH HHS K01 MD020215
6 · The paper itself

Abstract

BACKGROUND AND

aimsPer- and poly-fluoroalkyl substances (PFAS) are persistent chemicals that contaminate air, water, soil, and food. Due to their widespread use, PFAS are detectable in most of the US population, raising concerns about potential health impacts, including a possible association with colorectal cancer (CRC). We conducted a scoping review of previously published studies to consolidate the current understanding of PFAS and its effect on CRC risk, identify knowledge gaps, and propose future directions for research.

methodsWe systematically searched PubMed, Scopus, and Web of Science for studies published through December 2024 that examined PFAS exposure in relation to CRC risk or progression. Data were independently extracted using a standardized protocol and structured according to a predefined Population, Exposure, Comparator, Outcome (PECO) framework. To evaluate internal validity, studies were categorized by evidence stream (in vitro, animal, and epidemiological) and assessed using established quality appraisal criteria.

resultsTwenty-six studies were identified, including 5 reviews, 3 in vitro studies, 6 animal studies, and 12 epidemiological studies. In vitro research consistently demonstrates that PFAS exposure promotes CRC cell proliferation and migration, highlighting key mechanistic pathways. However, findings from animal and epidemiological studies are mixed, with some indicating increased intestinal tumorigenesis while others report null or protective effects. Notably, major studies were cross-sectional, retrospective, or ecological, emphasizing the need for high-quality longitudinal research to clarify PFAS's role in CRC risk and progression.

conclusionEvidence on the relationship between PFAS exposure and CRC risk remains limited and inconclusive. Large-scale, prospective epidemiological studies that incorporate biomarker-based exposure assessment, including pre-diagnostic PFAS levels, diverse populations, and rigorous study design are needed to clarify the role of PFAS in CRC development. Such research could provide the role of PFAS in CRC development and progression, guiding public health policies and support targeted interventions to reduce CRC risk.

Indexed as

Colorectal NeoplasmsEnvironmental ExposureEnvironmental PollutantsFluorocarbonsAnimalsHumansEnvironmental PollutantsFluorocarbonsAnimal StudiesColorectal CancerEpidemiological StudiesIn Vitro StudiesPer- and polyfluoroalkyl substances (PFAS)Scoping Review

Identifiers

PMID40939531
PMCPMC12661558

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.