Case-Control Study of Arsenic in Drinking Water and Kidney Cancer in Uniquely Exposed Northern Chile

• Published in: American journal of epidemiology 2013-09, Vol.178 (5), p.813-818
• Main Authors: FERRECCIO, Catterina, SMITH, Allan H, PEREZ, Liliana, YAN YUAN, LIAW, Jane, CANTOR, Kenneth P, STEINMAUS, Craig, DURAN, Viviana, BARLARO, Teresa, BENITEZ, Hugo, VALDES, Rodrigo, AGUIRRE, Juan Jose, MOORE, Lee E, ACEVEDO, Johanna, VASQUEZ, María Isabel
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Arsenic; Arsenic - analysis; Arsenic - toxicity; Biological and medical sciences; Brief Original Contribution; Carcinogens; Case-Control Studies; Chile - epidemiology; Dose-Response Relationship, Drug; Drinking water; Epidemiology; Female; General aspects; Health Behavior; Human exposure; Humans; Kidney cancer; Kidney Neoplasms - chemically induced; Kidney Neoplasms - epidemiology; Kidneys; Male; Medical sciences; Middle Aged; Miscellaneous; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Nephrology. Urinary tract diseases; Odds Ratio; Public health. Hygiene; Public health. Hygiene-occupational medicine; Socioeconomic Factors; Tumors; Tumors of the urinary system; Water Pollutants, Chemical - analysis; Water Pollutants, Chemical - toxicity; Water Pollution, Chemical - statistics & numerical data; Water Supply - analysis; Young Adult
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwt059

Millions of people worldwide are exposed to arsenic in drinking water. The International Agency for Research on Cancer has concluded that ingested arsenic causes lung, bladder, and skin cancer. However, a similar conclusion was not made for kidney cancer because of a lack of research with individual data on exposure and dose-response. With its unusual geology, high exposures, and good information on past arsenic water concentrations, northern Chile is one of the best places in the world to investigate the carcinogenicity of arsenic. We performed a case-control study in 2007-2010 of 122 kidney cancer cases and 640 population-based controls with individual data on exposure and potential confounders. Cases included 76 renal cell, 24 transitional cell renal pelvis and ureter, and 22 other kidney cancers. For renal pelvis and ureter cancers, the adjusted odds ratios by average arsenic intakes of 1,000 µg/day (median water concentrations of 60, 300, and 860 µg/L) were 1.00, 5.71 (95% confidence interval: 1.65, 19.82), and 11.09 (95% confidence interval: 3.60, 34.16) (Ptrend < 0.001), respectively. Odds ratios were not elevated for renal cell cancer. With these new findings, including evidence of dose-response, we believe there is now sufficient evidence in humans that drinking-water arsenic causes renal pelvis and ureter cancer.