Understanding the Relationship between Environmental Arsenic and Prostate Cancer Aggressiveness among African-American and European-American Men in North Carolina

Humberto Parada, Tianying Wu, Rebecca C. Fry, Laura Farnan, Gary J. Smith, James L. Mohler and Jeannette T. Bensen
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Humberto Parada: Division of Epidemiology & Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA
Tianying Wu: Division of Epidemiology & Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA
Rebecca C. Fry: Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Laura Farnan: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Gary J. Smith: Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
James L. Mohler: Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
Jeannette T. Bensen: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA

IJERPH, 2020, vol. 17, issue 22, 1-13

Abstract: High-level exposure to arsenic, a known carcinogen and endocrine disruptor, is associated with prostate cancer (PCa) mortality. Whether low-level exposure is associated with PCa aggressiveness remains unknown. We examined the association between urinary arsenic and PCa aggressiveness among men in North Carolina. This cross-sectional study included 463 African-American and 491 European-American men with newly diagnosed, histologically confirmed prostate adenocarcinoma. PCa aggressiveness was defined as low aggressive (Gleason score < 7, stage = cT1–cT2, and PSA < 10 ng/mL) versus intermediate/high aggressive (all other cases). Total arsenic and arsenical species (inorganic arsenic (iAs III + iAs V ), arsenobetaine, monomethyl arsenic, and dimethyl arsenic)) and specific gravity were measured in spot urine samples obtained an average of 23.7 weeks after diagnosis. Multivariable logistic regression was used to estimate the covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for PCa aggressiveness in association with arsenic tertiles/quantiles overall and by race. The highest (vs. lowest) tertile of total arsenic was associated with PCa aggressiveness ORs of 1.77 (95% CI = 1.05–2.98) among European-American men, and 0.94 (95% CI = 0.57–1.56) among African-American men ( P Interaction = 0.04). In contrast, total arsenic and arsenical species were not associated with PCa aggressiveness in unstratified models. Low-level arsenic exposure may be associated with PCa aggressiveness among European-Americans, but not among African-Americans.

Keywords: prostate; cancer; environmental arsenic; inorganic arsenic (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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