Environmental Geochemistry and Health

, Volume 34, Issue 1, pp 15–26 | Cite as

Quality of drinking water and high incidence rate of esophageal cancer in Golestan province of Iran: a probable link

  • Behnam Keshavarzi
  • Farid Moore
  • Ali Najmeddin
  • Farah Rahmani
  • Ahad Malekzadeh
Original Paper


Golestan province in north Iran is known to be a high-risk area for esophageal cancer (EC). Of a long list of multiple risk factors, this study focuses on a possible link between the epidemiologic patterns of EC and the anomalous concentration of some ions and elements in the drinking water sources. A total of 183 samples from 45 villages covering a wide range of EC mortality rates are collected and analyzed. The results demonstrate that NO3, SO42−, Sb, and Sr exceed the recommended maximum concentration level (MCL) in drinking water. This is more prominent in the villages with high esophageal cancer mortality rate, suggesting a possible link between EC incidence and water quality. Se concentration in drinking water increases from low to the high EC areas, a finding contrary to the expected trend. It is concluded that Se deficiency does not play a major role in the etiology of EC in the Golestan province. The statistical results obtained from Mann–Whitney and Kruskal–Wallis tests along with cluster analysis are consistent with the observed trend of EC mortality rate in Golestan province.


Esophageal cancer Drinking water Golestan province Iran 



The authors wish to express their gratitude to M. Korei of Geological survey of Iran for financially supporting this research. We would also like to extend our thanks to the research committee of Shiraz University for logistic helps.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Behnam Keshavarzi
    • 1
  • Farid Moore
    • 1
  • Ali Najmeddin
    • 1
  • Farah Rahmani
    • 2
  • Ahad Malekzadeh
    • 3
  1. 1.Department of Earth Sciences, College of SciencesShiraz UniversityShirazIran
  2. 2.Geological Survey of IranMedical Geology GroupTehranIran
  3. 3.Department of Statistics, College of SciencesShiraz UniversityShirazIran

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