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Arsenic exposure predicts bladder cancer survival in a US population

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

Chronic arsenic exposure at levels found in US drinking water has been associated with bladder cancer. While arsenic is a known carcinogen, recent studies suggest that it is useful as a therapeutic agent for leukemia. This study examined the relationship between arsenic exposure and bladder cancer mortality.

Methods

We studied 832 cases of bladder cancer diagnosed in New Hampshire from a population-based case–control study. Individual exposure to arsenic was determined in home drinking water using ICP-MS and in toenail samples by instrumental neutron activation analysis.

Results

Among the high arsenic exposure group, found using toenail arsenic level or arsenic consumption, cases experienced a de-escalated survival hazard ratio (HR) [high (≥75 percent) versus low (<25th percentile) toenail arsenic overall survival HR 0.5 (95% CI 0.4–0.8)], controlled for tumor stage, grade, gender, age and treatment regimen. This association was found largely among invasive tumors, in smokers and was not modified by TP53 status. Bladder cancer cause-specific survival showed a similar trend, but did not reach statistical significance [HR 0.5 (95% CI 0.3–1.1)].

Conclusions

Arsenic exposure may be related to the survival of patients with bladder cancer.

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Acknowledgments

Funding for the study was provided by the National Institutes of Health (NIH): K07 CA102327, R03 CA121382, R03 CA99500, R01 CA57494 (NCI) and P20 RR018787 [National Center for Research Resources (NCRR) IDeA program], P42 ES07373 [National Institute for Environmental Health Sciences (NIEHS) and the Dartmouth Superfund Basic Research Program]. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Conflict of interest statement

There is no conflict of interest.

Author information

Authors and Affiliations

  1. Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Norris Cotton Cancer Center, Dartmouth Medical School, 7927 Rubin 860 One Medical Center Drive, Lebanon, NH, 03756, USA

    Ryan C. Kwong, Margaret R. Karagas, Rebecca A. Mason, Sam A. Tanyos & Angeline S. Andrew

  2. Department of Community Health/Epidemiology and Pathology and Laboratory Medicine, Center for Environmental Health and Technology, Brown University, Providence, RI, 02912, USA

    Karl T. Kelsey & Carmen J. Marsit

  3. Department of Pathology, Dartmouth Medical School, Lebanon, NH, 03756, USA

    Alan R. Schned

Authors
  1. Ryan C. Kwong
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  2. Margaret R. Karagas
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  3. Karl T. Kelsey
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  4. Rebecca A. Mason
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  5. Sam A. Tanyos
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  6. Alan R. Schned
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  7. Carmen J. Marsit
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  8. Angeline S. Andrew
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Corresponding author

Correspondence to Angeline S. Andrew.

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Kwong, R.C., Karagas, M.R., Kelsey, K.T. et al. Arsenic exposure predicts bladder cancer survival in a US population. World J Urol 28, 487–492 (2010). https://doi.org/10.1007/s00345-009-0477-y

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  • DOI: https://doi.org/10.1007/s00345-009-0477-y

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