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

Jaeil Ahn, Isabella J. Boroje, Hamid Ferdosi, Zachary J. Kramer and Steven H. Lamm
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Jaeil Ahn: Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University School of Medicine, Washington, DC 20007, USA
Isabella J. Boroje: Center for Epidemiology and Environmental Health (CEOH, LLC), Washington, DC 20016, USA
Hamid Ferdosi: Center for Epidemiology and Environmental Health (CEOH, LLC), Washington, DC 20016, USA
Zachary J. Kramer: Center for Epidemiology and Environmental Health (CEOH, LLC), Washington, DC 20016, USA
Steven H. Lamm: Center for Epidemiology and Environmental Health (CEOH, LLC), Washington, DC 20016, USA

IJERPH, 2020, vol. 17, issue 3, 1-16

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