Research on the Epidemiology of Prostate Cancer and Environmental Levels (REPEL)

Evidence is accumulating for potential prostate cancer risks associated with high exposure to endocrine-disrupting chemicals6 9. For example, per- and polyfluoroalkyl Substances (PFAS) are a class of thousands of chemicals, many of which are commonly used in consumer products and industrial processes for their non-stick and water-resistant properties10. Health concerns related to PFAS have emerged due to their tendency to bioaccumulate and ubiquitous presence in humans and wildlife worldwide10 12. An estimated 98% of Americans have detectable levels of commonly measured PFAS13. Although industry began voluntarily phasing out use of several long-chain PFAS in the early 2000 s, concerns remain due to the large number of PFAS still in use, their persistence in the environment and humans, and growing evidence of harms from animal and epidemiologic studies11,14 17.

I will study associations of drinking water chemical exposures with risk of advanced stage CaP at diagnosis and racial disparities in CaP outcomes. I will conduct a pilot study to identify sources of common endocrine disrupting chemicals and associations with CaP progression within a racially diverse sample of CaP survivors recruited from New Brunswick, New Jersey, treated at the Rutgers Cancer Institute of New Jersey (CINJ). I will pursue the following specific aims:

1. Compare PFAS sources across racial groups and estimate longitudinal associations between serum PFAS and PSA levels. We will conduct a pilot study in CaP survivors treated in New Jersey to demonstrate feasibility of recruitment, data, and sample collection. Preliminary data will inform establishment of a future cohort of CaP survivors to evaluate environmental factors affecting survivorship and prognosis. Participants will provide serum and tap water samples, and complete a questionnaire to capture water consumption patterns, occupational history, and dietary information. Samples will be analyzed for a panel of 14 short and long-chain PFAS. We will evaluate associations between serum and tap water PFAS, dietary patterns, and spatially modeled levels across racial/ethnic groups using linear regression and principal components analysis. We will study associations between serum PFAS and repeated PSA measures obtained from health records. Synergistic impacts of PFAS mixtures on PSA will be assessed using quantile g-computation.

2. Estimate associations of PFAS mixtures with prostate cancer tumor characteristics, symptoms and quality of life. We will capture clinical information on prostate cancer progression and outcomes from medical records and linkage with the New Jersey State Cancer Registry. Information on prostate cancer symptoms and quality of life will be ascertained from participant questionnaires.

For further information about clinical trials, please contact us at 732-235-7356.