Cadmium exposure and cancer mortality in a prospective cohort: the strong heart study.

MedStar author(s):
Citation: Environmental Health Perspectives. 122(4):363-70, 2014 Apr.PMID: 24531129Institution: 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: *Cadmium/to [Toxicity] | *Neoplasms/ep [Epidemiology] | *Neoplasms/mo [Mortality] | Aged | Environmental Exposure/ae [Adverse Effects] | Female | Humans | Male | Middle Aged | Prospective StudiesYear: 2014Local holdings: Available online from MWHC library: 1972 - presentISSN:
  • 0091-6765
Name of journal: Environmental health perspectivesAbstract: BACKGROUND: Cadmium (Cd) is a toxic metal classified as a human carcinogen by the International Agency for Research on Cancer.CONCLUSIONS: Low-to-moderate Cd exposure was prospectively associated with total cancer mortality and with mortality from cancers of the lung and pancreas. The implementation of population-based preventive measures to decrease Cd exposure could contribute to reducing the burden of cancer.METHODS: The Strong Heart Study was a prospective cohort study of 3, 792 men and women 45-74 years of age who were followed for up to 20 years. Baseline urinary Cd (U-Cd) was measured using inductively coupled plasma mass spectrometry. We assessed cancer events by annual mortality surveillance.OBJECTIVE: We evaluated the association of long-term Cd exposure, as measured in urine, with cancer mortality in American Indians from Arizona, Oklahoma, and North and South Dakota who participated in the Strong Heart Study during 1989-1991.RESULTS: The median (interquintile range) U-Cd concentration was 0.93 (0.55, 1.63) mug/g creatinine. After adjusting for sex, age, smoking status, cigarette pack-years, and body mass index, the adjusted hazard ratios (HRs) comparing the 80th versus the 20th percentiles of U-Cd were 1.30 (95% CI: 1.09, 1.55) for total cancer, 2.27 (95% CI: 1.58, 3.27) for lung cancer, and 2.40 (95% CI: 1.39, 4.17) for pancreatic cancer mortality. For all smoking-related cancers combined, the corresponding HR was 1.56 (95% CI: 1.24, 1.96). Cd was not significantly associated with liver, esophagus and stomach, colon and rectum, breast, prostate, kidney, or lymphatic and hematopoietic cancer mortality. On the basis of mediation analysis, we estimated that the percentage of lung cancer deaths due to tobacco smoking that could be attributed to Cd exposure was 9.0% (95% CI: 2.8, 21.8).All authors: Best LG, Francesconi KA, Garcia-Esquinas E, Goessler W, Guallar E, Navas-Acien A, Pollan M, Tellez-Plaza M, Umans JG, Yeh JFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2015-03-17
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 24531129 Available 24531129

Available online from MWHC library: 1972 - present

BACKGROUND: Cadmium (Cd) is a toxic metal classified as a human carcinogen by the International Agency for Research on Cancer.

CONCLUSIONS: Low-to-moderate Cd exposure was prospectively associated with total cancer mortality and with mortality from cancers of the lung and pancreas. The implementation of population-based preventive measures to decrease Cd exposure could contribute to reducing the burden of cancer.

METHODS: The Strong Heart Study was a prospective cohort study of 3, 792 men and women 45-74 years of age who were followed for up to 20 years. Baseline urinary Cd (U-Cd) was measured using inductively coupled plasma mass spectrometry. We assessed cancer events by annual mortality surveillance.

OBJECTIVE: We evaluated the association of long-term Cd exposure, as measured in urine, with cancer mortality in American Indians from Arizona, Oklahoma, and North and South Dakota who participated in the Strong Heart Study during 1989-1991.

RESULTS: The median (interquintile range) U-Cd concentration was 0.93 (0.55, 1.63) mug/g creatinine. After adjusting for sex, age, smoking status, cigarette pack-years, and body mass index, the adjusted hazard ratios (HRs) comparing the 80th versus the 20th percentiles of U-Cd were 1.30 (95% CI: 1.09, 1.55) for total cancer, 2.27 (95% CI: 1.58, 3.27) for lung cancer, and 2.40 (95% CI: 1.39, 4.17) for pancreatic cancer mortality. For all smoking-related cancers combined, the corresponding HR was 1.56 (95% CI: 1.24, 1.96). Cd was not significantly associated with liver, esophagus and stomach, colon and rectum, breast, prostate, kidney, or lymphatic and hematopoietic cancer mortality. On the basis of mediation analysis, we estimated that the percentage of lung cancer deaths due to tobacco smoking that could be attributed to Cd exposure was 9.0% (95% CI: 2.8, 21.8).

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