Geographic patterns of hepatocellular carcinoma mortality with exposure to iron in groundwater in Taiwanese population: an ecological study

• Published in: BMC public health 2013-04, Vol.13 (1), p.352-352, Article 352
• Main Authors: Shyu, Horng-Jeng, Lung, Chia-Chi, Ho, Chien-Chang, Sun, Yi-Hua Iris, Ko, Pei-Chieh, Huang, Jing-Yang, Pan, Chia-Chen, Chiang, Yi-Chen, Chen, Shih-Chang, Liaw, Yung-Po
• Format: Article
• Language: English
• Subjects: Adolescent; Aged, 80 and over; Carcinoma, Hepatocellular - mortality; Child; Child, Preschool; Cluster Analysis; Environmental Exposure - adverse effects; Female; Geographic Information Systems; Geography, Medical; Groundwater; Groundwater - chemistry; Health aspects; Hepatitis B; Hepatitis B virus; Hepatitis C; Hepatoma; Humans; Hypotheses; Immunization; Infant; Iron; Iron - poisoning; Liver cancer; Liver Neoplasms - mortality; Male; Males; Medical research; Medicine, Experimental; Mortality; Public health; Registries; Risk Factors; Taiwan - epidemiology; Water, Underground
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/1471-2458-13-352

Many studies have examined the risk factors for HCC (including hepatitis B virus, hepatitis C virus, aflatoxin, retinol, cigarette smoking, and alcohol consumption). However, data from previous studies on the association between iron exposure, land subsidence, and HCC mortality/incidence were limited, especially in Taiwanese population. We aimed to explore the geographical distribution of HCC mortality rates by township-specific data and to evaluate the association between HCC mortality, land subsidence, and iron levels in groundwater in Taiwan. We conducted an ecological study and calculated the HCC age-standardized mortality/incidence rates according to death certificates issued in Taiwan from 1992 to 2001 and incidence data from 1995-1998. The land subsidence dataset before 2005 and iron concentrations in groundwater in 1989 are also involved in this study. Both geographical information systems and Pearson correlation coefficients were used to analyze the relationship between HCC mortality rates, land subsidence, and iron concentrations in groundwater. Township-specific HCC mortality rates are higher in southwestern coastal townships where serious land subsidence and higher township-specific concentrations of iron in groundwater are present. The Pearson correlation coefficients of iron concentrations in groundwater and ASRs of HCC were 0.286 (P = 0.004) in males and 0.192 (P = 0.058) in females for mortality data; the coefficients were 0.375 (P