Smoking and metabolism phenotype interact with inorganic arsenic in causing bladder cancer

摘要

This study aimed to quantify bladder cancer relative risks in relation to inorganic arsenic (As) exposure below 100 μg/L in drinking water and the potential modifying effects of As metabolism and cigarette smoking. A case-control study was conducted in areas of Hungary, Romania, and Slovakia. Cases were histologically confirmed cases of bladder cancer and controls were general surgery, orthopedic, and trauma patients. Exposure indices were constructed based on information on As intake over lifetime of participants. The study recruited 185 cases of histologically verified bladder cancer and 540 controls. The estimated effect of As on cancer was stronger in participants with urinary markers indicating inefficient metabolism of As. By smoking category moderate smokers showed lower As-related risks than either never smokers or heavy smokers. We found a positive association between urothelial cancer and exposure to iAs through drinking water at concentrations below 100 μg/L.