title: Case-control study of arsenic in drinking water and kidney cancer in uniquely exposed Northern Chile.
abstract: 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 <400, 400-1,000, and >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.
authors.affiliation: Departamento de Salud Publica, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: Allan H
authors.initials: AH
authors.lastname: Smith
authors.forename: Viviana
authors.initials: V
authors.lastname: Durán
authors.forename: Teresa
authors.initials: T
authors.lastname: Barlaro
authors.forename: Hugo
authors.initials: H
authors.lastname: Benítez
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Valdés
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Aguirre
authors.forename: Lee E
authors.initials: LE
authors.lastname: Moore
authors.forename: Johanna
authors.initials: J
authors.lastname: Acevedo
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Vásquez
authors.forename: Liliana
authors.initials: L
authors.lastname: Pérez
authors.forename: Yan
authors.initials: Y
authors.lastname: Yuan
authors.forename: Jane
authors.initials: J
authors.lastname: Liaw
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Cantor
authors.forename: Craig
authors.initials: C
authors.lastname: Steinmaus
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001151:Arsenic / Q000032:analysis / Q000633:toxicity*; D016022:Case-Control Studies; D002677:Chile / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D015438:Health Behavior; D006801:Humans; D007680:Kidney Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012959:Socioeconomic Factors; D014874:Water Pollutants, Chemical / Q000032:analysis / Q000633:toxicity*; D014877:Water Pollution, Chemical / Q000706:statistics & numerical data; D014881:Water Supply / Q000032:analysis*; D055815:Young Adult
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic
keywords: Chile; arsenic; case-control; drinking water; kidney cancer