Tanya Alderete

PhD

Johns Hopkins University

Tenure-Track Associate Professor

PLCO (Learn more about this study)

PLCO-1977

Sep 9, 2025

Integrating PFAS Exposure, Metabolomics, and Genetics to Address Colorectal Cancer Risk

Colorectal cancer (CRC) is the third most common cancer diagnosed in the US and the second leading cause of cancer-related deaths. While incidence rates have been declining in older adults due to improved screening and treatment, an alarming trend has emerged among younger adults (under 55), where CRC incidence has been increasing by 1-2% per year since the mid-1990s. Notably, rising incidence rates are particularly prevalent among African American and Native American populations, underscoring the importance of identifying additional modifiable risk factors to prevent and reduce the burden of CRC. Per- and poly-fluoroalkyl substances (PFAS), a class of persistent synthetic chemicals used in consumer products and industrial processes, are detectable in more than 97% of the U.S. population. Due to the uneven geographic distribution of contamination sources, residents of low-income and racial and ethnic groups often have higher PFAS concentrations. PFAS exposure is more prevalent in low-income and minority communities, and emerging evidence suggests that it may contribute to CRC risk through metabolic and inflammatory pathways. Indeed, legacy PFAS compounds have been classified by IARC as class 1 and 2B carcinogens. By leveraging existing untargeted small molecule profiling (metabolomics), and polygenic risk scores (PRS), our proposed study aims to uncover how PFAS exposure influences CRC risk and colorectal adenomas.

Aim 1: Examine the associations between plasma levels of PFAS with CRC risk as well as colorectal adenomas using existing metabolomics data and assess whether genetic predisposition modifies these associations using a CRC polygenic risk score.

Aim 2: Investigate the associations between existing metabolomics data with CRC risk and colorectal adenomas and assess whether genetic predisposition modifies these associations using a CRC polygenic risk score.