title: Increased lung and bladder cancer incidence in adults after in utero and early-life arsenic exposure.
abstract: BACKGROUND
  From 1958 to 1970, >100,000 people in northern Chile were exposed to a well-documented, distinct period of high drinking water arsenic concentrations. We previously reported ecological evidence suggesting that early-life exposure in this population resulted in increased mortality in adults from several outcomes, including lung and bladder cancer.
  
  
  METHODS
  We have now completed the first study ever assessing incident cancer cases after early-life arsenic exposure, and the first study on this topic with individual participant exposure and confounding factor data. Subjects included 221 lung and 160 bladder cancer cases diagnosed in northern Chile from 2007 to 2010, and 508 age and gender-matched controls.
  
  
  RESULTS
  ORs adjusted for age, sex, and smoking in those only exposed in early life to arsenic water concentrations of ≤110, 110 to 800, and >800 μg/L were 1.00, 1.88 [95% confidence interval (CI), 0.96-3.71], and 5.24 (3.05-9.00; P(trend) < 0.001) for lung cancer, and 1.00, 2.94 (1.29-6.70), and 8.11 (4.31-15.25; P(trend) < 0.001) for bladder cancer. ORs were lower in those not exposed until adulthood. The highest category (>800 μg/L) involved exposures that started 49 to 52 years before, and ended 37 to 40 years before the cancer cases were diagnosed.
  
  
  CONCLUSIONS
  Lung and bladder cancer incidence in adults was markedly increased following exposure to arsenic in early life, even up to 40 years after high exposures ceased. Such findings have not been identified before for any environmental exposure, and suggest that humans are extraordinarily susceptible to early-life arsenic exposure.
  
  
  CONCLUSIONS
  Policies aimed at reducing early-life exposure may help reduce the long-term risks of arsenic-related disease.
authors.affiliation: Arsenic Health Effects Research Program, University of California, Berkeley, Berkeley; Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland; craigs@berkeley.edu.
authors.forename: Craig
authors.initials: C
authors.lastname: Steinmaus
authors.affiliation: Pontificia Universidad Catolica de Chile, Facultad de Medicina, CENTRO FONDAP/ACCDIS, Santiago, Chile.
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.affiliation: Pontificia Universidad Catolica de Chile, Facultad de Medicina, CENTRO FONDAP/ACCDIS, Santiago, Chile.
authors.forename: Johanna
authors.initials: J
authors.lastname: Acevedo
authors.affiliation: Arsenic Health Effects Research Program, University of California, Berkeley, Berkeley;
authors.forename: Yan
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Arsenic Health Effects Research Program, University of California, Berkeley, Berkeley;
authors.forename: Jane
authors.initials: J
authors.lastname: Liaw
authors.affiliation: Hospital Regional de Arica Dr. Juan Noé;
authors.forename: Viviana
authors.initials: V
authors.lastname: Durán
authors.affiliation: Centro de Salud Familiar Iris Veliz Hume, Arica;
authors.forename: Susana
authors.initials: S
authors.lastname: Cuevas
authors.affiliation: Hospital Regional de Iquique Dr. Ernesto Torres Galdames, Iquique;
authors.forename: José
authors.initials: J
authors.lastname: García
authors.affiliation: Hospital Regional de Calama, Calama;
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Meza
authors.affiliation: Laboratorio Histonor;
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Valdés
authors.affiliation: Laboratorio Histonor;
authors.forename: Gustavo
authors.initials: G
authors.lastname: Valdés
authors.affiliation: Hospital Regional de Antofagasta Dr. Leonardo Guzmán, Antofagasta; and.
authors.forename: Hugo
authors.initials: H
authors.lastname: Benítez
authors.affiliation: Hospital Regional de Antofagasta Dr. Leonardo Guzmán, Antofagasta; and.
authors.forename: Vania
authors.initials: V
authors.lastname: VanderLinde
authors.affiliation: Pontificia Universidad Católica de Chile, Facultad de Medicina, Santiago;
authors.forename: Vania
authors.initials: V
authors.lastname: Villagra
authors.affiliation: KP Cantor Environmental LLC, Silver Springs;
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Cantor
authors.affiliation: National Cancer Institute, Bethesda, Maryland;
authors.forename: Lee E
authors.initials: LE
authors.lastname: Moore
authors.affiliation: Global Health Sciences Program, University of California, San Francisco, San Francisco;
authors.forename: Saida G
authors.initials: SG
authors.lastname: Perez
authors.affiliation: Biological Sciences Department, California Polytechnic State University, San Luis Obispo, California;
authors.forename: Scott
authors.initials: S
authors.lastname: Steinmaus
authors.affiliation: Arsenic Health Effects Research Program, University of California, Berkeley, Berkeley;
authors.forename: Allan H
authors.initials: AH
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D001151:Arsenic / Q000009:adverse effects*; D020261:Arsenic Poisoning / Q000453:epidemiology; D002677:Chile / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*; D014874:Water Pollutants, Chemical / Q000009:adverse effects*; D014877:Water Pollution, Chemical / Q000009:adverse effects
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic