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. 2015 Oct:142:594-601.
doi: 10.1016/j.envres.2015.07.021.

Obesity and excess weight in early adulthood and high risks of arsenic-related cancer in later life

Craig Steinmaus  1 , Felicia Castriota  2 , Catterina Ferreccio  3 , Allan H Smith  4 , Yan Yuan  4 , Jane Liaw  4 , Johanna Acevedo  3 , Liliana Pérez  3 , Rodrigo Meza  5 , Sergio Calcagno  6 , Ricardo Uauy  7 , Martyn T Smith  8
Affiliations

Obesity and excess weight in early adulthood and high risks of arsenic-related cancer in later life

Craig Steinmaus et al. Environ Res. 2015 Oct.

Abstract

Background: Elevated body mass index (BMI) is a risk factor for cardiovascular disease, diabetes, cancer, and other diseases. Inflammation or oxidative stress induced by high BMI may explain some of these effects. Millions of people drink arsenic-contaminated water worldwide, and ingested arsenic has also been associated with inflammation, oxidative stress, and cancer.

Objectives: To assess the unique situation of people living in northern Chile exposed to high arsenic concentrations in drinking water and investigate interactions between arsenic and BMI, and associations with lung and bladder cancer risks.

Methods: Information on self-reported body mass index (BMI) at various life stages, smoking, diet, and lifetime arsenic exposure was collected from 532 cancer cases and 634 population-based controls.

Results: In subjects with BMIs <90th percentile in early adulthood (27.7 and 28.6 kg/m(2) in males and females, respectively), odds ratios (OR) for lung and bladder cancer combined for arsenic concentrations of <100, 100-800 and >800 µg/L were 1.00, 1.64 (95% CI, 1.19-2.27), and 3.12 (2.30-4.22). In subjects with BMIs ≥90th percentile in early adulthood, the corresponding ORs were higher: 1.00, 1.84 (0.75-4.52), and 9.37 (2.88-30.53), respectively (synergy index=4.05, 95% CI, 1.27-12.88). Arsenic-related cancer ORs >20 were seen in those with elevated BMIs in both early adulthood and in later life. Adjustments for smoking, diet, and other factors had little impact.

Conclusion: These findings provide novel preliminary evidence supporting the notion that environmentally-related cancer risks may be markedly increased in people with elevated BMIs, especially in those with an elevated BMI in early-life.

Keywords: Arsenic; BMI; Bladder cancer; Cancer; Chile; Drinking water; Inflammation; Lung cancer; Obesity.

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Conflict of interest statement

Competing financial interests: Dr. Steinmaus has done consulting work on arsenic toxicity for both industry and environmental groups. The other authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Odds ratios of lung and bladder cancer combined for various categories of highest known arsenic drinking water concentrations stratified by BMIs above (“High”) and below (“Low”) the 90th percentile at age 20, at age 40, and in the 10 years preceding interviewa aThose with a highest known arsenic water concentrations <100 μg/L are used as the reference category. ORs are adjusted for age, sex, and smoking.
Figure 2
Figure 2
Plots of lung and bladder cancer combined odds ratios based on logistic regression equations by arsenic water concentrations in subjects with BMIs ≥90th percentile at various life stagesa Abbreviations: b, regression coefficient for the increase in log odds ratio of cancer for each 100 μg/L increase in arsenic water concentration aOdds ratios are adjusted for age, sex, and smoking
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