Cancer
The Association Between Metal and Metalloids and Bladder Cancer Risk in the New England Bladder Cancer Study Maria E. Kamenetsky* Maria Kamenetsky Stella Koutros Margaret Karagas Molly Schwenn Alison Johnson Debra T. Silverman Alexander P. Keil
Trace elements, including essential/nonessential metal and metalloids (“metals”), are of interest in the etiology of cancer due to their carcinogenic properties and potential protective properties of essential metals. The combined mixture effect of multiple co-occurring metals on bladder cancer (BC) is not well understood. While previous studies have explored associations between individual metals and BC, there has been limited work in exploring the overall mixture effect of these metals, or by essential or nonessential groupings. We leveraged the New England Bladder Cancer Study (NEBCS), a population-based case-control study, to estimate associations between a mixture of 12 metals and bladder cancer. Toenail clipping samples were obtained from 1213 cases and 1418 controls at time of the interview and analyzed for 7 essential and 5 nonessential metals (Fig 1). Using a novel Bayesian implementation of quantile g-computation, we assessed associations between bladder cancer risk and the overall metals mixture, as well the partial effect associations of essential and nonessentials metals. After adjustment for covariates and factors used for frequency matching (i.e., age, gender, state), we estimated an inverse association between bladder cancer and the overall mixture of metals (odds ratio (OR): 0.76, 95% confidence interval (CI): 0.62-0.92) using standard quantile g-computation. When considered separately, there was limited, but similar evidence of association for essential (OR: 0.85, 95% CI: 0.66-1.08) and nonessential (OR: 0.89, 95% CI: 0.73-1.10) metals. Results were relatively unchanged after omitting adjustment for common sources of metals exposure (diet, occupation). ORs from the Bayesian approach under weak priors were similar. Our findings suggest an overall reduction in risk associated with trace elements on bladder cancer risk in the US general population of Northern New England.
