Prostate Cancer Incidence in U.S. Counties and Low Levels of Arsenic in Drinking Water
Abstract
:1. Introduction
2. Materials and Methods
2.1. Arsenic Exposure Data
2.2. Alternative Carcinogenic Exposures
2.3. Prostate Cancer Incidence Data
2.4. Demographic Data
2.5. Geographical Mapping
2.6. Statistical Analysis
3. Results
3.1. Location
3.2. Population Characteristics
3.2.1. Outcome
3.2.2. Exposure
3.2.3. Demographics
3.3. Poisson Regression Models
3.4. Sensitivity Analyses
3.5. Stratified Analysis
4. Discussion
4.1. Epidemiological Studies
4.2. Arsenic metabolism
4.3. Arsenic Toxicology
4.4. Carcinogenicity Studies
4.5. Mode of Action
4.6. Dose-Response Models
4.7. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Median | Mean | Minimum | Maximum |
---|---|---|---|---|
Outcome | ||||
Prostate Cancer Rate (per 100,000) | 116.4 | 117.9 | 44.8 | 220.3 |
Count (5-year estimate) | 111 | 442 | 10 | 12,652 |
Exposure | ||||
Dependency | 87% | 76% | 10% | 100% |
Well Count | 2 | 8.1 | 1 | 190 |
As Median (ug/L) | 0.9 | 2.1 | 0.7 | 52.5 |
As Minimum (μg/L) | 0.7 | 1.3 | 0.7 | 42 |
As Maximum (μg/L) | 1.0 | 7.96 | 0.7 | 190 |
Co-Variates | ||||
Current Smoker (%) | 25.6 | 25.3 | 9.54 | 40.0 |
Ex-Smoker (%) | 29.6 | 29.9 | 15.9 | 48.3 |
Obesity (%) | 31.9 | 31.2 | 15.1 | 41.2 |
Education (<HS) (%) | 84.3 | 83.0 | 58.6 | 97.4 |
Residency (Same County) (%) | 94 | 93 | 78 | 98 |
Poverty (%) | 14 | 15 | 3 | 48 |
Income ($K) | 44.8 | 47.3 | 23.9 | 106.1 |
Rural (%) | 48 | 49 | 0 | 100 |
Population | ||||
Male Population | 19,977 | 71,914 | 1,698 | 2,037,405 |
Hispanic (%) | 4 | 9 | 0 | 80 |
White (%) | 92 | 87 | 20 | 99 |
Black (%) | 2 | 7 | 0 | 69 |
Asian (%) | 1 | 1 | 0 | 22 |
Other (%) | 2 | 4 | 1 | 79 |
Unadjusted | Exposure Range for Median Arsenic Level | ||
---|---|---|---|
All | Without Outliers | Without Non-Significants + | |
Unadjusted Median Model | |||
N | 715 | 712 | 712 |
Arsenic2 | 0.0007 *** | 0.0005 *** | 0.0005 *** |
Arsenic | −0.0310 *** | −0.0225 *** | −0.0225 *** |
Intercept | −5.0460 *** | −5.0480 *** | −5.0480 *** |
Adjusted | All | Without Outliers | Without Non-Significants + |
Adjusted Median Model | |||
N | 710 | 707 | 707 |
Arsenic2 | 0.0003 *** | 0.0002 *** | 0.0002 *** |
Arsenic | −0.0105 *** | −0.0044 ** | −0.0043 ** |
GW Dependency | 0.0243 *** | 0.0204 ** | 0.0196 ** |
Current Smoker | −0.0031 *** | −0.0019 ** | −0.0192 ** |
Ex-Smoker | 0.0016 * | 0.0002 | - |
Radon (>4 pCi/L) | −0.0229 *** | −0.0380 *** | −0.02869 *** |
Obesity | −0.0044 *** | −0.0028 *** | −0.0029 *** |
Education (<HS grad) | −0.0023 *** | −0.0001 | - |
Residency (Same cnty) | 0.5992 *** | 0.9458 *** | 0.9353 *** |
Income (MHHI $K) | 0.0001 | 0.0006 | −0.8308 *** |
Poverty | −0.9332 *** | −0.8308 *** | - |
Rural | −0.0976 *** | −0.0972 *** | −0.0952 *** |
Hispanic | −0.2762 *** | 0.7371 *** | 0.2969 *** |
Black | 0.7872 *** | −0.2438 *** | −0.7414 *** |
Asian | 0.1804 *** | 0.370 | - |
Other | −0.1993 *** | −0.1950 *** | −0.1988 *** |
Intercept | −5.1643 *** | −5.7424 *** | −5.7519 *** |
Variable | Maximum + <100 μg/L | Median + <50 μg/L | Dependency > 80 μg/L |
---|---|---|---|
N | 695 | 707 | 392 |
Arsenic2 | 0.0001 ** | 0.0002 *** | 0.0003 *** |
Arsenic | −0.0015 | −0.0044 ** | −0.0090 *** |
GW Dependency | 0.0354 *** | 0.0204 ** | −0.3562 *** |
Current Smoker | −0.0010 | −0.0019 ** | −0.0026 ** |
Ex-Smoker | −0.0010 | −0.0002 | −0.00465 *** |
Radon (>4 pCi/L) | −0.0397 *** | −0.0380 *** | −0.0491 *** |
Obesity | −0.0040 | −0.0028 *** | −0.0046 *** |
Education (<HS grad) | 0.0029 *** | −0.0001 | 0.0038 *** |
Residency (same cnty) | 1.1929 *** | 0.9458 *** | 1.4419 *** |
Income (MHHI $K) | −0.0004 | 0.0006 | 0.0017 ** |
Poverty | −0.7191 *** | −0.8193 *** | −0.6423 *** |
Rural | −0.0813 *** | −0.0972 *** | −0.0966 *** |
Hispanic | −0.1367 *** | 0.2371 *** | −0.4040 *** |
Black | 0.7731 *** | 0.7438 *** | 0.5714 *** |
Asian | −0.0387 | −0.0370 | 0.5339 *** |
Other | −0.2432 *** | −0.1950 ** | −0.4291 *** |
Intercept | −6.2642 *** | −5.7423 *** | −5.6349 *** |
Regression Model | Poisson | Negative-Binomial |
---|---|---|
Adjusted Median Model | ||
N | 710 | 710 |
Arsenic2 | 0.0003 *** | 0.0002 * |
Arsenic | −0.0105 *** | −0.0050 |
GW Dependency | 0.0243 *** | 0.0432 |
Current Smoker | −0.0031 *** | −0.0068 ** |
Ex-Smoker | 0.0016 * | −0.0014 |
Radon (>4 pCi/L) | −0.0229 *** | 0.0086 |
Obesity | −0.0044 *** | −0.0003 |
Education (<HS grad) | −0.0023 *** | 0.0011 |
Residency (same cnty) | 0.5992 *** | 0.7427 ** |
Income (MHHI $K) | 0.0001 | −0.0005 |
Poverty | −0.9332 *** | −0.7564 ** |
Rural | −0.0976 *** | −0.1123 ** |
Hispanic | -0.0262 *** | −0.2405 * |
Black | 0.7872 *** | 0.7987 *** |
Asian | 0.1804 *** | −0.0654 |
Other | −0.1993 *** | −0.1028 |
Intercept | −5.1643 *** | −5.5708 *** |
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Share and Cite
Ahn, J.; Boroje, I.J.; Ferdosi, H.; Kramer, Z.J.; Lamm, S.H. Prostate Cancer Incidence in U.S. Counties and Low Levels of Arsenic in Drinking Water. Int. J. Environ. Res. Public Health 2020, 17, 960. https://doi.org/10.3390/ijerph17030960
Ahn J, Boroje IJ, Ferdosi H, Kramer ZJ, Lamm SH. Prostate Cancer Incidence in U.S. Counties and Low Levels of Arsenic in Drinking Water. International Journal of Environmental Research and Public Health. 2020; 17(3):960. https://doi.org/10.3390/ijerph17030960
Chicago/Turabian StyleAhn, Jaeil, Isabella J. Boroje, Hamid Ferdosi, Zachary J. Kramer, and Steven H. Lamm. 2020. "Prostate Cancer Incidence in U.S. Counties and Low Levels of Arsenic in Drinking Water" International Journal of Environmental Research and Public Health 17, no. 3: 960. https://doi.org/10.3390/ijerph17030960