title: Obesity and excess weight in early adulthood and high risks of arsenic-related cancer in later life.
abstract: BACKGROUND
  Elevated body mass index (BMI) is a risk factor for cardiovascular disease, diabetes, cancer, and other diseases. Inflammation or oxidative stress induced by high BMI may explain some of these effects. Millions of people drink arsenic-contaminated water worldwide, and ingested arsenic has also been associated with inflammation, oxidative stress, and cancer.
  
  
  OBJECTIVE
  To assess the unique situation of people living in northern Chile exposed to high arsenic concentrations in drinking water and investigate interactions between arsenic and BMI, and associations with lung and bladder cancer risks.
  
  
  METHODS
  Information on self-reported body mass index (BMI) at various life stages, smoking, diet, and lifetime arsenic exposure was collected from 532 cancer cases and 634 population-based controls.
  
  
  RESULTS
  In subjects with BMIs <90th percentile in early adulthood (27.7 and 28.6 kg/m(2) in males and females, respectively), odds ratios (OR) for lung and bladder cancer combined for arsenic concentrations of <100, 100-800 and >800 µg/L were 1.00, 1.64 (95% CI, 1.19-2.27), and 3.12 (2.30-4.22). In subjects with BMIs ≥90th percentile in early adulthood, the corresponding ORs were higher: 1.00, 1.84 (0.75-4.52), and 9.37 (2.88-30.53), respectively (synergy index=4.05, 95% CI, 1.27-12.88). Arsenic-related cancer ORs >20 were seen in those with elevated BMIs in both early adulthood and in later life. Adjustments for smoking, diet, and other factors had little impact.
  
  
  CONCLUSIONS
  These findings provide novel preliminary evidence supporting the notion that environmentally-related cancer risks may be markedly increased in people with elevated BMIs, especially in those with an elevated BMI in early-life.
authors: Arsenic Health Effects Research Program, School of Public Health, University of California, 50 University Hall, MC7360, Berkeley, CA 94720-7360, USA; Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, USA. Electronic address: craigs@berkeley.edu.
authors: Craig
authors: C
authors: Steinmaus
authors: Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York City, USA.
authors: Felicia
authors: F
authors: Castriota
authors: Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Catterina
authors: C
authors: Ferreccio
authors: Arsenic Health Effects Research Program, School of Public Health, University of California, 50 University Hall, MC7360, Berkeley, CA 94720-7360, USA.
authors: Allan H
authors: AH
authors: Smith
authors: Arsenic Health Effects Research Program, School of Public Health, University of California, 50 University Hall, MC7360, Berkeley, CA 94720-7360, USA.
authors: Yan
authors: Y
authors: Yuan
authors: Arsenic Health Effects Research Program, School of Public Health, University of California, 50 University Hall, MC7360, Berkeley, CA 94720-7360, USA.
authors: Jane
authors: J
authors: Liaw
authors: Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Johanna
authors: J
authors: Acevedo
authors: Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Liliana
authors: L
authors: Pérez
authors: Hospital Regional de Calama, Calama, Chile.
authors: Rodrigo
authors: R
authors: Meza
authors: Hospital Regional de Iquique, Iquique, Chile.
authors: Sergio
authors: S
authors: Calcagno
authors: London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom; Instituto de Nutrición y Technología de los Alimentos, Universidad de Chile, Santiago, Chile.
authors: Ricardo
authors: R
authors: Uauy
authors: Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, USA.
authors: Martyn T
authors: MT
authors: Smith
mesh_terms: D000328:Adult; D001151:Arsenic / Q000633:toxicity*; D015992:Body Mass Index; D002677:Chile; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000150:complications; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D055815:Young Adult
chemical_list: D001151:Arsenic
keywords: Arsenic; BMI; Bladder cancer; Cancer; Chile; Drinking water; Inflammation; Lung cancer; Obesity