Abstract PD4-01: Preservative Food Additives and Breast Cancer Incidence in the NutriNet-Santé Cohort

Abstract Background Experimental studies suggested negative impacts of some preservative food additives via mechanisms involving advanced glycation end products and mutagenic and potentially carcinogenic activities, but human data are lacking. This study aimed to investigate for the first time the associations between exposures to a wide range of preservative food additives and cancer incidence, in particular breast cancer, in a large population-based cohort. Methods Participants (n=105,260; 78.7% women; mean age=42.0y SD=14.5) from the French NutriNet-Santé prospective cohort (2009-2023) completed repeated 24h dietary records (mean=21 SD=18), including industrial food brands. Cumulative time-dependent exposure to food additives was evaluated using multiple composition databases and ad hoc laboratory assays in food matrices. Associations between exposure to preservatives (3 categories: sex-specific tertiles or non-exposed/lower/higher exposed participants separated by the sex-specific median) and cancer incidence were characterised using proportional hazards Cox models adjusted for potential confounders. Results 4226 incident cancer cases were diagnosed (mean follow-up=7.57y; SD=4.56) (incl. 1208 breast, 508 prostate, and 352 colorectal cancers). Regarding breast cancer, higher intakes of the following additives were associated with higher incidence: potassium sorbate with (Hazard Ratio (HR)cat3vs.1= 1.26[1.07-1.49]); potassium metabisulphite (1.20[1.04-1.38]); potassium nitrate (1.22[1.05-1.41]); and sodium erythorbate (1.21[1.04-1.41]). Some associations were also observed for overall, prostate and colorectal cancers. Conclusions This large prospective cohort revealed multiple positive associations between exposure to widely used preservatives and higher cancer incidence. If confirmed, these new data could lead to a re-evaluation of the safety of these food additives by European and international public health agencies to improve consumer protection. Citation Format: A. Hasenböhler, M. Payen de la Garanderie, F. Szabo de Edelenyi, C. Agaësse, A. De Sa, I. Huybrechts, S. Hercberg, L. Zelek, M. Deschasaux-Tanguy, B. Srour, M. Touvier. Preservative Food Additives and Breast Cancer Incidence in the NutriNet-Santé Cohort [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PD4-01.