Skin Cancer Risk in Relation to Toenail Arsenic Concentrations in a US Population-based Case-Control Study

Arsenic is a known carcinogen specifically linked to skin cancer occurrence in regions with highly contaminated drinking water or in individuals who took arsenic-containing medicines. Presently, it is unknown whether such effects occur at environmental levels found in the United States. To address t...

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Bibliographic Details
Published in:American journal of epidemiology 2001-03, Vol.153 (6), p.559-565
Main Authors: Karagas, Margaret R., Stukel, Therese A., Morris, J. Steven, Tosteson, Tor D., Weiss, Julia E., Spencer, Steven K., Greenberg, E. Robert
Format: Article
Language:English
Subjects:
Adult
Aged
arsenic
Arsenic - analysis
basal cell
basal cell carcinoma
BCC
Biological and medical sciences
Carcinoma, Basal Cell - chemically induced
Carcinoma, Basal Cell - epidemiology
Carcinoma, Squamous Cell - chemically induced
Carcinoma, Squamous Cell - epidemiology
Case-Control Studies
confidence interval
Confounding Factors (Epidemiology)
Dermatology
Environmental Exposure - analysis
Female
heavy
Humans
Interviews as Topic
Logistic Models
Male
Medical sciences
metals
Middle Aged
Nails - chemistry
neoplasms
New Hampshire - epidemiology
Risk Factors
SCC
skin neoplasms
Skin Neoplasms - chemically induced
Skin Neoplasms - epidemiology
squamous cell
squamous cell carcinoma
standard error
Toes
Tumors of the skin and soft tissue. Premalignant lesions
water
Water - chemistry
Water Supply
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Summary:Arsenic is a known carcinogen specifically linked to skin cancer occurrence in regions with highly contaminated drinking water or in individuals who took arsenic-containing medicines. Presently, it is unknown whether such effects occur at environmental levels found in the United States. To address this question, the authors used data collected on 587 basal cell and 284 squamous cell skin cancer cases and 524 controls interviewed as part of a case-control study conducted in New Hampshire between 1993 and 1996. Arsenic was determined in toenail clippings using instrumental neutron activation analysis. The odds ratios for squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) were close to unity in all but the highest category. Among individuals with toenail arsenic concentrations above the 97th percentile, the adjusted odds ratios were 2.07 (95% confidence interval (CI): 0.92, 4.66) for SCC and 1.44 (95% CI: 0.74, 2.81) for BCC, compared with those with concentrations at or below the median. While the risks of SCC and BCC did not appear elevated at the toenail arsenic concentrations detected in most study subjects, the authors cannot exclude the possibility of a dose-related increase at the highest levels of exposure experienced in the New Hampshire population.
ISSN:0002-9262
1476-6256
0002-9262
DOI:10.1093/aje/153.6.559