title: The association of drinking water source and chlorination by-products with cancer incidence among postmenopausal women in Iowa: a prospective cohort study.
abstract: OBJECTIVE
  This study assessed the association of drinking water source and chlorination by-product exposure with cancer incidence.
  
  
  METHODS
  A cohort of 28,237 Iowa women reported their drinking water source. Exposure to chlorination by-products was determined from statewide water quality data.
  
  
  RESULTS
  In comparison with women who used municipal ground-water sources, women with municipal surface water sources were at an increased risk of colon cancer and all cancers combined. A clear dose-response relation was observed between four categories of increasing chloroform levels in finished drinking water and the risk of colon cancer and all cancers combined. The relative risks were 1.00, 1.06, 1.39, and 1.68 for colon cancer and 1.00, 1.04, 1.24, and 1.25 for total cancers. No consistent association with either water source or chloroform concentration was observed for other cancer sites.
  
  
  CONCLUSIONS
  These results suggest that exposure to chlorination by-products in drinking water is associated with increased risk of colon cancer.
authors.affiliation: Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Doyle
authors.forename: W
authors.initials: W
authors.lastname: Zheng
authors.forename: J R
authors.initials: JR
authors.lastname: Cerhan
authors.forename: C P
authors.initials: CP
authors.lastname: Hong
authors.forename: T A
authors.initials: TA
authors.lastname: Sellers
authors.forename: L H
authors.initials: LH
authors.lastname: Kushi
authors.forename: A R
authors.initials: AR
authors.lastname: Folsom
mesh_terms: D002713:Chlorine / Q000009:adverse effects; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007484:Iowa / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology*; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D014881:Water Supply
chemical_list: D002713:Chlorine