environmental harms affecting cancer. The role of known metal carcinogens (i.e., cadmium, arsenic, nickel, chromium(VI))

Overview

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Key numbers

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• census tracts. Among colorectal cancer (n = 56,598) and female breast cancer (n = 77,637) diagnoses in Kentucky, we used
• logistic regression models to estimate Odds Ratios (ORs) and 95% Confidence Intervals to examine the association between
• female breast cancer (n = 77,679) and primary colorectal quality model integrating information on emissions, mete-
• mates. However, to understand the variability of potential invasive breast cancer (6.6%) and 115 were hotspots for male
• exposure over a longer period of time, we calculated the or female colorectal cancer (10.4%) (Fig. 1). The distribu-
• metal over twelve years (e.g., arsenic in 2002 and 2014) as Supplemental Table 1, which are within the Occupational
• regression models to estimate odds ratios (OR) and 95% rural settings, due to many industries in KY located near
• breast cancer hotspot (n = 77,637) or colorectal cancer hot- coefficients assessing each metal concentration from 2002
• spot (n = 56,598). The metal exposures were modeled con- and 2014 were 0.71 for arsenic, 0.85 for cadmium, 0.71 for
• tinuously per a standard deviation (SD) increase and cat- chromium, and 0.70 for nickel (Supplemental Table 2) indi-
• level characteristics that differed by hotspot status, then sub- Table 1 presents the characteristics of the 77,637 female
• term, followed by census-tract level characteristics that dif- In this study, 5044 (6.5%) breast cancer cases resided in an
• Breast cancer cases with missing values for median women, 5.8% resided in a breast cancer hotspot. Compared
• household income (n = 26), percentage of families below to cases who did not reside in a breast cancer hotspot, the
• poverty line (n = 26), and mammography screening (n = 2) breast cancer cases that resided in an invasive breast cancer
• line (n = 19), colorectal cancer screening (n = 3), percentage level characteristics, those living in a breast cancer hotspot
• who smoked cigarettes (n = 1), and lack of physical activity lived in more densely populated areas, areas with a higher
• (n = 1) were assigned the median values. A missing indicator percentage of families living below the poverty line, higher
• the extreme outliers (85) for ambient hexavalent chromium There were 5290 (9.4%) colorectal cancer cases that lived
• in breast cancer analyses (outliers n = 2718, 3.5%) and in a colorectal cancer hotspot. Among the 4.4 million people
• colorectal cancer analyses (outliers n = 2026, 3.6%). We living in KY in 2018, 8.5% of Kentuckians lived in a colo-
• a hotspot (Table 1). In addition, the hotspot cases were more as strong in magnitude when assessing SD increases in arse-
• likely to live in census tracts with a lower percentage of the nic (OR = 1.36 95% CI 1.32, 1.39), chromium (OR = 1.03
• population screened for colorectal cancer, a higher percent- 95% CI 1.00, 1.06) or nickel (OR = 1.30 95% CI 1.26, 1.33).
• metals compared to cases not in a hotspot. with residing in a breast cancer hotspot (OR = 1.69 95% CI
• centrations of ambient arsenic, cadmium, chromium, or 95% CI 1.88, 2.54, Model 6). These associations were simi-
• nickel had higher odds of residing in a breast cancer hot- lar for arsenic (Tertile 3 vs. Tertile 1: OR = 1.66 95% CI
• spot after adjustment for individual-level confounders and 1.43, 1.94) and nickel (Tertile 3 vs. Tertile 1: OR = 2.31 95%
• showing weak confounding relative to the crude results. The (Supplemental Table 3). The results were similar when we
• subsequent inclusion of population density and a quadratic restricted to never smokers (Supplemental Table 4) and to
• term for population density (Model 2), census-tract level invasive breast cancer cases (Supplementary Table 5).
• median household income (Model 5), and other variables showed positive associations with residing in a colorectal
• (Model 6) attenuated the results—most notably population cancer hotspot (Table 3). Among colorectal cancer cases, a
• Table 1 Individual and census-tract level characteristics of kentucky breast cancer cases (n = 77,637) and colorectal cancer cases (n = 56,598) by
• breast cancer hotspot cancer hotspot (n = 72,593) cancer hotspot (n = 5,290) colorectal cancer hotspot
• Male, % (n) – – 48.5 (2,564) 51.1 (26,204)
• Table 1 (continued)
• breast cancer hotspot cancer hotspot (n = 72,593) cancer hotspot (n = 5,290) colorectal cancer hotspot
• % Physically inactive 31.0 (9.6) 33.0 (6.7) 37.6 (6.9) 33.7 (6.5)
• Values are means (SD) or medians (Q25, Q75) for continuous variables; percentages or ns or both for categorical variables
• Values of categorical variables may not sum to 100% due to rounding
• cancer hotspot in the fully adjusted model (OR = 2.08 95% In summary, we observed that cancer cases who lived in cen-

Methods (brief)

• without outcome data, leaving a total analytic sample of for estimates of ambient concentrations (ng/m3) of arsenic
• residing in a colorectal cancer hotspot. soil samples in eight southern US cities (including two KY
• 48. Aballay LR, Díaz MP, Francisca FM, Muñoz SE (2012) Can- 65. Baastrup R, Sørensen M, Balstrøm T et al (2008) Arsenic in

Implications

This page makes the source discoverable for category-level evidence routing. Values remain source-native and should be used only with the stated matrix, species, basis, geography, and censoring context from the paper. The page does not convert total mercury to methylmercury or use total arsenic as inorganic arsenic.

Wiki pages this source may touch

• Fish — marine, non-predatory (sardines, anchovies, salmon, cod)
• Seaweed/kelp foods (nori, wakame, kombu, dulse — as food products)
• Cadmium
• Arsenic
• Nickel
• Chromium

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Update history

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