Federal health agencies and peer-reviewed scientific literature have examined associations between PFAS exposure and a range of health conditions. The following summary is drawn from publicly available findings by the Agency for Toxic Substances and Disease Registry (ATSDR), the National Academies of Sciences Engineering and Medicine (NASEM), the National Institute of Environmental Health Sciences (NIEHS), and published epidemiological studies.

This page does not constitute medical advice. The strength of association between PFAS exposure and specific health outcomes continues to be studied and varies across the scientific literature.

Kidney Cancer (Renal Cell Carcinoma)

Kidney cancer is among the most studied health outcomes in populations with documented PFAS exposure. Epidemiological studies of communities with contaminated drinking water and of occupationally exposed workers have found elevated rates of kidney cancer in some — though not all — exposed populations.

The C8 Science Panel, an independent scientific panel commissioned as part of a class-action settlement involving a DuPont chemical plant in West Virginia, reviewed data from approximately 69,000 residents exposed to PFOA-contaminated drinking water. The panel concluded that there was a probable link between PFOA exposure and kidney cancer based on available evidence at the time of their review.

The National Academies 2022 report on PFAS health effects concluded that sufficient evidence exists for an association between PFAS exposure and kidney cancer, placing it in a category supporting a clinical presumption of association.

PFOA and PFOS are the PFAS compounds most frequently studied in connection with kidney cancer risk. Both are present in AFFF formulations used by the military.

Testicular Cancer (Testicular Germ Cell Tumors)

Testicular cancer has been studied in several PFAS-exposed populations, including military firefighters and residents of communities with contaminated water supplies.

A 2023 study published in a peer-reviewed environmental health journal examined PFAS blood levels in active-duty military firefighters and found elevated levels of PFAS compounds associated with increased risk of testicular germ cell tumors. Military firefighters, including those who used AFFF in training and operational contexts, were among the study populations examined.

The C8 Science Panel also found a probable link between PFOA exposure and testicular cancer. The National Academies 2022 report placed testicular cancer in the category of sufficient evidence for an association with PFAS exposure.

Testicular cancer is one of the conditions for which the scientific evidence of a PFAS-exposure association is considered among the strongest in the published literature.

Thyroid Disease and Thyroid Cancer

The thyroid gland is sensitive to chemical disruption because PFAS compounds can interfere with thyroid hormone production and metabolism. Research has examined associations between PFAS exposure and thyroid function abnormalities, hypothyroidism, and thyroid cancer.

The ATSDR’s 2021 Toxicological Profile for Perfluoroalkyls reviewed studies finding associations between PFAS exposure and altered thyroid hormone levels. The National Academies 2022 report found limited or suggestive evidence for an association between PFAS exposure and thyroid disease and thyroid cancer — a category indicating some evidence of association while acknowledging the limitations of existing research.

Studies of firefighters and military personnel have included thyroid outcomes as endpoints of interest given the occupational intensity of AFFF exposure in these populations.

Ulcerative Colitis

Ulcerative colitis, a chronic inflammatory bowel disease, has been examined in PFAS-exposed populations. The C8 Science Panel found a probable link between PFOA exposure and ulcerative colitis among the West Virginia study population.

Ulcerative colitis represents a significant proportion of the AFFF personal injury litigation docket. Legal filings in the multidistrict litigation (MDL 2873) in the District of South Carolina include ulcerative colitis as a qualifying condition. Attorneys and experts in that litigation have cited the C8 probable link finding and subsequent epidemiological studies in their filings.

Bladder Cancer

Bladder cancer has been examined in several studies of PFAS-exposed populations. Evidence for an association between PFAS exposure and bladder cancer is characterized in federal agency reviews as limited or suggestive — meaning some studies have found positive associations, but the evidence base is not as strong as for kidney or testicular cancer.

The National Academies 2022 report reviewed available evidence for bladder cancer and other urological outcomes. Research in this area is ongoing.

Liver Disease and Liver Cancer

PFAS accumulate preferentially in liver tissue, and research has examined hepatic effects of PFAS exposure including elevated liver enzymes, non-alcoholic fatty liver disease, and liver cancer.

The ATSDR toxicological profile for PFAS documents findings from animal and human studies on liver effects. The National Academies 2022 report reviewed evidence for liver disease and hepatocellular carcinoma in exposed populations.

Other Conditions Under Study

Scientific investigation of PFAS health effects is ongoing. Conditions currently examined in published literature and federal agency research programs include:

  • Prostate cancer
  • Breast cancer
  • Non-Hodgkin’s lymphoma
  • Pancreatic cancer
  • Immune system effects (reduced vaccine response documented in children)
  • Pregnancy-induced hypertension and preeclampsia
  • Reduced birth weight

The National Institute of Environmental Health Sciences and the National Cancer Institute maintain active research programs examining PFAS health effects in various populations.

Key Federal Reference Documents

The following publicly available documents form the primary scientific basis for PFAS health effect evaluations:

  • ATSDR Toxicological Profile for Perfluoroalkyls (2021) — comprehensive review of animal and human health data for PFOA, PFOS, and related compounds. Available at atsdr.cdc.gov.
  • National Academies of Sciences, Engineering, and Medicine — PFAS Exposure and Health Effects (2022) — independent review commissioned to support VA and DoD decision-making on PFAS health outcomes. Available at nap.nationalacademies.org.
  • EPA IRIS Assessment for PFOA and PFOS — EPA’s formal hazard identification and dose-response assessments. Available at epa.gov/iris.
  • C8 Science Panel Findings (2011–2012) — peer-reviewed probable link determinations for PFOA exposure and specific health conditions, based on the Parkersburg, WV exposed community study. Published findings available in scientific literature.
  • VA PFAS Public Health Resources — available at publichealth.va.gov/exposures/pfas.asp.