Arsenic exposure and cancer mortality in a US-based prospective cohort: the strong heart study.[Erratum appears in Cancer Epidemiol Biomarkers Prev. 2013 Aug;22(8):1479]

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Citation: Cancer Epidemiology, Biomarkers & Prevention. 22(11):1944-53, 2013 Nov.PMID: 23800676Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., Extramural | Research Support, Non-U.S. Gov'tSubject headings: *Arsenic Poisoning/eh [Ethnology] | *Arsenic Poisoning/ep [Epidemiology] | *Neoplasms/ci [Chemically Induced] | *Neoplasms/eh [Ethnology] | Aged | Arizona/ep [Epidemiology] | Arsenic Poisoning/ur [Urine] | Arsenic/ur [Urine] | Environmental Exposure/ae [Adverse Effects] | Environmental Exposure/sn [Statistics & Numerical Data] | Female | Humans | Incidence | Male | Middle Aged | Neoplasms/mo [Mortality] | Neoplasms/ur [Urine] | North Dakota/ep [Epidemiology] | Oklahoma/ep [Epidemiology] | Proportional Hazards Models | Risk Assessment | South Dakota/ep [Epidemiology] | Survival AnalysisYear: 2013Local holdings: Available online from MWHC library: Nov 1991 - present (after 1 year)ISSN:
  • 1055-9965
Name of journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive OncologyAbstract: BACKGROUND: Inorganic arsenic, a carcinogen at high exposure levels, is a major global health problem. Prospective studies on carcinogenic effects at low-moderate arsenic levels are lacking.CONCLUSIONS: Low to moderate exposure to inorganic arsenic was prospectively associated with increased mortality for cancers of the lung, prostate, and pancreas.IMPACT: These findings support the role of low-moderate arsenic exposure in development of lung, prostate, and pancreas cancer and can inform arsenic risk assessment. 2013 AACR.METHODS: We evaluated the association between baseline arsenic exposure and cancer mortality in 3,932 American Indians, 45 to 74 years of age, from Arizona, Oklahoma, and North/South Dakota who participated in the Strong Heart Study from 1989 to 1991 and were followed through 2008. We estimated inorganic arsenic exposure as the sum of inorganic and methylated species in urine. Cancer deaths (386 overall, 78 lung, 34 liver, 18 prostate, 26 kidney, 24 esophagus/stomach, 25 pancreas, 32 colon/rectal, 26 breast, and 40 lymphatic/hematopoietic) were assessed by mortality surveillance reviews. We hypothesized an association with lung, liver, prostate, and kidney cancers.RESULTS: Median (interquartile range) urine concentration for inorganic plus methylated arsenic species was 9.7 (5.8-15.6) mug/g creatinine. The adjusted HRs [95% confidence interval (CI)] comparing the 80th versus 20th percentiles of arsenic were 1.14 (0.92-1.41) for overall cancer, 1.56 (1.02-2.39) for lung cancer, 1.34 (0.66, 2.72) for liver cancer, 3.30 (1.28-8.48) for prostate cancer, and 0.44 (0.14, 1.14) for kidney cancer. The corresponding hazard ratios were 2.46 (1.09-5.58) for pancreatic cancer, and 0.46 (0.22-0.96) for lymphatic and hematopoietic cancers. Arsenic was not associated with cancers of the esophagus and stomach, colon and rectum, and breast.All authors: Best LG, Farley J, Francesconi KA, Garcia-Esquinas E, Goessler W, Guallar E, Howard B, Navas-Acien A, Pollan M, Umans JGFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2014-04-04
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 23800676 Available 23800676

Available online from MWHC library: Nov 1991 - present (after 1 year)

BACKGROUND: Inorganic arsenic, a carcinogen at high exposure levels, is a major global health problem. Prospective studies on carcinogenic effects at low-moderate arsenic levels are lacking.

CONCLUSIONS: Low to moderate exposure to inorganic arsenic was prospectively associated with increased mortality for cancers of the lung, prostate, and pancreas.

IMPACT: These findings support the role of low-moderate arsenic exposure in development of lung, prostate, and pancreas cancer and can inform arsenic risk assessment. 2013 AACR.

METHODS: We evaluated the association between baseline arsenic exposure and cancer mortality in 3,932 American Indians, 45 to 74 years of age, from Arizona, Oklahoma, and North/South Dakota who participated in the Strong Heart Study from 1989 to 1991 and were followed through 2008. We estimated inorganic arsenic exposure as the sum of inorganic and methylated species in urine. Cancer deaths (386 overall, 78 lung, 34 liver, 18 prostate, 26 kidney, 24 esophagus/stomach, 25 pancreas, 32 colon/rectal, 26 breast, and 40 lymphatic/hematopoietic) were assessed by mortality surveillance reviews. We hypothesized an association with lung, liver, prostate, and kidney cancers.

RESULTS: Median (interquartile range) urine concentration for inorganic plus methylated arsenic species was 9.7 (5.8-15.6) mug/g creatinine. The adjusted HRs [95% confidence interval (CI)] comparing the 80th versus 20th percentiles of arsenic were 1.14 (0.92-1.41) for overall cancer, 1.56 (1.02-2.39) for lung cancer, 1.34 (0.66, 2.72) for liver cancer, 3.30 (1.28-8.48) for prostate cancer, and 0.44 (0.14, 1.14) for kidney cancer. The corresponding hazard ratios were 2.46 (1.09-5.58) for pancreatic cancer, and 0.46 (0.22-0.96) for lymphatic and hematopoietic cancers. Arsenic was not associated with cancers of the esophagus and stomach, colon and rectum, and breast.

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