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. 2020 Feb 4;17(3):960.
doi: 10.3390/ijerph17030960.

Prostate Cancer Incidence in U.S. Counties and Low Levels of Arsenic in Drinking Water

Jaeil Ahn  1 , Isabella J Boroje  2   3   4 , Hamid Ferdosi  2   3 , Zachary J Kramer  2 , Steven H Lamm  2   5   6
Affiliations

Prostate Cancer Incidence in U.S. Counties and Low Levels of Arsenic in Drinking Water

Jaeil Ahn et al. Int J Environ Res Public Health. .

Abstract

Background: Although inorganic arsenic in drinking water at high levels (100s-1000s μg/L [ppb]) increases cancer risk (skin, bladder, lung, and possibly prostate), the evidence at lower levels is limited. Methods: We conducted an ecologic analysis of the dose-response relationship between prostate cancer incidence and low arsenic levels in drinking water in a large study of U.S. counties (N = 710). County arsenic levels were <200 ug/L with median <100 ug/L and dependency greater than 10%. Groundwater well usage, water arsenic levels, prostate cancer incidence rates (2009-2013), and co-variate data were obtained from various U.S. governmental agencies. Poisson and negative-binomial regression analyses and stratified analysis were performed. Results: The best fitting polynomial analysis yielded a J-shaped linear-quadratic model. Linear and quadratic terms were significant (p < 0.001) in the Poisson model, and the quadratic term was significant (p < 0.05) in the negative binomial model. This model indicated a decreasing risk of prostate cancer with increasing arsenic level in the low range and increasing risk above. Conclusions: This study of prostate cancer incidence in US counties with low levels of arsenic in their well-water arsenic levels finds a j-shaped model with decreasing risk at very low levels and increasing risk at higher levels.

Keywords: drinking water; linear-quadratic model; low level arsenic exposure; prostate cancer.

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Conflict of interest statement

Authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Map of U.S. Counties the in Arsenic and Prostate Cancer Study.
Figure 2
Figure 2
Stratified Analysis of Age-Adjusted Prostate Cancer Incidence Rate by Median Groundwater Well Arsenic Exposure Strata for US Counties.
See this image and copyright information in PMC

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