Persistent Environmental Pollutants and Cancer Outcomes: Evidences from Community Cohort Studies

Persistent environmental pollutants (POPs) including radionuclides, per- and polyfluoroalkyl substances (PFAS), and heavy metals pose a significant global cancer burden. However, a systematic synthesis of evidence from key environmental disaster cohorts is limited. This review addresses this gap by consolidating findings from landmark community studies, namely the Fernald, Hanford, and Love Canal cohorts, to elucidate specific exposure-cancer relationships. The analysis demonstrates clear exposure-response dynamics, such lung cancer mortality associated with uranium exposure in Fernald cohort and increase in thyroid cancer risk per gray of iodine-131 radiation dose in Hanford site. While methodological challenges such as latency periods and historical exposure assessment persist, the cumulative evidence robustly supports causal inferences. The review underscores the critical importance of regulatory frameworks, including the EPA Superfund program and NIEHS community-based initiatives, for remediation and public health surveillance. Future research must prioritize integrative exposomic frameworks, advanced biomonitoring techniques, and environmental justice principles to effectively mitigate the public health impact of legacy contamination.