American Journal of Epidemiology Vol. 153, No. 6 : 559-565
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Skin Cancer Risk in Relation to Toenail Arsenic Concentrations in a US Population-based Case-Control Study
1 Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, NH.
2 Norris Cotton Cancer Center, Dartmouth Medical School, Lebanon, NH.
3 Research Reactor Center, University of Missouri, Columbia, MO.
4 Department of Medicine, Dartmouth Medical School, Lebanon, NH.
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.
arsenic; case-control studies; metals, heavy; neoplasms, basal cell; neoplasms, squamous cell; skin neoplasms; water
Abbreviations: BCC, basal cell carcinoma; CI, confidence interval; SCC, squamous cell carcinoma; SE, standard error
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