Associations between the Exposure of Polycyclic Aromatic Hydrocarbons and the Risk of Cancers Related to Deregulation of Estrogen Receptors: NHANES 2001-2016

Abstract Background: Estrogen receptor signaling is one of the most investigated pathways that associates with the endocrine-disrupting abilities of polycyclic aromatic hydrocarbons (PAHs). This study we aimed to investigate the relationships between specific PAHs exposure and cancers associated with estrogen receptor (ER) deregulation. Methods: We conducted a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) 2001-2016 data. A history of the four types of cancers related to ERs deregulation (prostate, breast, uterine and ovarian cancer) was obtained by self-report. Exposure of PAHs was assessed by measuring ten urinary PAH metabolites. Logistic regression models were fitted to estimate the associations between specific urinary PAHs (uPAHs) and each type of cancers. Results: Exposure to certain uPAHs metabolites was linked to an increased risk of breast, uterine, and ovarian cancers. Notably, 9-hydroxyfluorene (9-OHFlu) demonstrated a dose-response relationship with elevated breast cancer risk (OR [95%CI]: 2.39 [1.09, 5.23], p for trend <0.001). Tertile analyses indicated that 2-Hydroxyfluorene (2-OHFlu) and 1-Hydroxypyrene (1-OHPyr) might increase the risk of breast and uterine cancer, respectively. Conversely, 2-Hydroxynapthalene (2-OHNap) and 1-Hydroxyphenanthrene (1-OHPhe) might be protect factors of ovarian cancer. No significant associations were found between the ten uPAHs metabolites and prostate cancer. Conclusions: Our study suggested that PAHs exposure was associated with an increased risk of breast cancer, particularly 9-OHFlu, in a dose-response manner. Additionally, PAHs exposure might increase the incidence of uterine cancer but decrease the risk of ovarian cancer.