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Colorectal cancer risk and nitrate exposure through drinking water and diet
Espejo-Herrera, Nadia Gràcia-Lavedan, Esther Boldo, Elena Aragonés, Nuria Pérez-Gómez, Beatriz Pollán, Marina Molina, Antonio J. Fernández, Tania Martín, Vicente La Vecchia, Carlo
Espejo-Herrera, Nadia
Gràcia-Lavedan, Esther
Boldo, Elena
Aragonés, Nuria
Pérez-Gómez, Beatriz
Pollán, Marina
Molina, Antonio J.
Fernández, Tania
Martín, Vicente
La Vecchia, Carlo
Author
Espejo-Herrera, Nadia
Gràcia-Lavedan, Esther
Boldo, Elena
Aragonés, Nuria
Pérez-Gómez, Beatriz
Pollán, Marina
Molina, Antonio J.
Fernández, Tania
Martín, Vicente
La Vecchia, Carlo
Bosetti, Cristina
Tavani, Alessandra
Polesel, Jerry
Serraino, Diego
Acebo, Inés Gómez
Altzibar, Jone M.
Ardanaz, Eva
Burgui, Rosana
Pisa, Federica
Fernández-Tardón, Guillermo
Tardón, Adonina
Peiró, Rosana
Navarro, Carmen
Castaño-Vinyals, Gemma
Moreno, Victor
Righi, Elena
Aggazzotti, Gabriella
Basagaña, Xavier
Nieuwenhuijsen, Mark J.
Kogevinas, Manolis
Villanueva, Cristina M.
Gràcia-Lavedan, Esther
Boldo, Elena
Aragonés, Nuria
Pérez-Gómez, Beatriz
Pollán, Marina
Molina, Antonio J.
Fernández, Tania
Martín, Vicente
La Vecchia, Carlo
Bosetti, Cristina
Tavani, Alessandra
Polesel, Jerry
Serraino, Diego
Acebo, Inés Gómez
Altzibar, Jone M.
Ardanaz, Eva
Burgui, Rosana
Pisa, Federica
Fernández-Tardón, Guillermo
Tardón, Adonina
Peiró, Rosana
Navarro, Carmen
Castaño-Vinyals, Gemma
Moreno, Victor
Righi, Elena
Aggazzotti, Gabriella
Basagaña, Xavier
Nieuwenhuijsen, Mark J.
Kogevinas, Manolis
Villanueva, Cristina M.
Abstract
Ingested nitrate leads to the endogenous synthesis of N‐nitroso compounds (NOCs), animal carcinogens with limited human evidence. We aimed to evaluate the risk of colorectal cancer (CRC) associated with nitrate exposure in drinking water and diet. A case‐control study in Spain and Italy during 2008‐2013 was conducted. Hospital‐based incident cases and population‐based (Spain) or hospital‐based (Italy) controls were interviewed on residential history, water consumption since age 18, and dietary information. Long‐term waterborne ingested nitrate was derived from routine monitoring records, linked to subjects’ residential histories and water consumption habits. Dietary nitrate intake was estimated from food frequency questionnaires and published food composition databases. Odd ratios (OR) were calculated using mixed models with area as random effect, adjusted for CRC risk factors and other covariables. Generalized additive models (GAMs) were used to analyze exposure‐response relationships. Interaction with endogenous nitrosation factors and other covariables was also evaluated. In total 1,869 cases and 3,530 controls were analyzed. Average waterborne ingested nitrate ranged from 3.4 to 19.7 mg/day, among areas. OR (95% CIs) of CRC was 1.49 (1.24, 1.78) for >10 versus ≤5 mg/day, overall. Associations were larger among men versus women, and among subjects with high red meat intake. GAMs showed increasing exposure‐response relationship among men. Animal‐derived dietary nitrate was associated with rectal, but not with colon cancer risk. In conclusion, a positive association between CRC risk and waterborne ingested nitrate is suggested, mainly among subgroups with other risk factors. Heterogeneous effects of nitrate from different sources (water, animal and vegetables) warrant further research.
Keywords
colorectal cancer, nitrate, drinking water, diet, case-control studies
Date
2016
Type
Journal article
Journal
International Journal of Cancer
Book
Volume
139
Issue
2
Page Range
334-346
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled