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Cancer Causes & Control

, Volume 19, Issue 8, pp 829–839 | Cite as

Arsenic exposure, urinary arsenic speciation, and the incidence of urothelial carcinoma: a twelve-year follow-up study

  • Yung-Kai Huang
  • Ya-Li Huang
  • Yu-Mei Hsueh
  • Mo-Hsiung Yang
  • Meei-Maan Wu
  • Shu-Yuan Chen
  • Ling-I Hsu
  • Chien-Jen Chen
Original Paper

Abstract

The risk of urothelial carcinoma (UC) and urinary arsenic speciation have been evaluated in a few case–control studies; however, the association has not been verified in a prospective cohort study. The aim of this study was to examine the association between urinary arsenic speciation and the incidence of UC in a cohort study. A total of 1,078 residents of southwestern Taiwan were followed for an average of 12 years. A high-performance liquid chromatography/hydride generator and an atomic absorption spectrometry were used to measure urinary arsenite, arsenate, monomethylarsonic acid (MMAV), and dimethylarsinic acid (DMAV). The incidence of UC was estimated by examining the National Cancer Registry of Taiwan between January 1985 and December 2001. There were 37 newly diagnosed cases of UC during a follow-up period of 11,655 person-years. Significantly higher percentages of MMAV and lower percentages of DMAV existed among the patients with UC than among the healthy residents. After adjustment for age, gender, educational level, and smoking status, the percentage of urinary DMAV was shown to have an inverse association with the risk of UC, having a relative risk (RR) of the tertile strata of 1.0, 0.3, and 0.3, respectively (p < 0.05 for the trend test). The RR (95% confidence interval) of residents with a cumulative arsenic exposure (CAE) of ≥20 mg/l-year and a higher percentage of MMAV or a CAE of ≥20 mg/l-year and a lower percentage of DMAV was 3.7 (1.2–11.6) or 4.2 (1.3–13.4) compared to residents with a CAE of <20 mg/l-year and a lower percentage of MMAV or a CAE of <20 mg/l-year and a higher percentage of DMAV respectively. There was a significant association between inefficient arsenic methylation and the development of UC in the residents in the high CAE exposure strata in an area of southwestern Taiwan endemic for arseniasis.

Keywords

Urinary arsenic species Long-term arsenic exposure Urothelial carcinoma risk 

Abbreviations

UC

Urothelial carcinoma

% DMAV

Percentage of DMAV

%InAsV

Percentage of InAs

%MMAV

Percentage of MMAV

AsIII

Arsenite

AsV

Arsenate

InAs

Inorganic arsenic

BFD

Blackfoot disease

CAE

Cumulative arsenic exposure

DMAV

Dimethylarsinic acid

InAs

Inorganic arsenic

MMAV

Monomethylarsonic acid

PMI

Primary methylation indices

SIRs

Standardized incidence ratios

SMI

Secondary methylation index

Notes

Acknowledgments

The study was supported by grants (NSC-89-2320-B038-013, NSC-89-2314-B038-049, NSC-90-2320-B-038-021, NSC91-3112-B-038-0019, NSC92-2321-B-038-004, NSC92-3112-B-038-001, NSC93-2321-B-038-012, NSC93-3112-B-038-001, NSC94-2314-B-038-023, and NSC95-2314-B-038-007) from the National Science Council, Executive Yuan, ROC.

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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Yung-Kai Huang
    • 1
  • Ya-Li Huang
    • 2
  • Yu-Mei Hsueh
    • 2
  • Mo-Hsiung Yang
    • 3
  • Meei-Maan Wu
    • 2
  • Shu-Yuan Chen
    • 4
  • Ling-I Hsu
    • 5
  • Chien-Jen Chen
    • 5
    • 6
  1. 1.Graduate Institute of Medical Sciences, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  2. 2.Department of Public Health, School of MedicineTaipei Medical UniversityTaipeiTaiwan
  3. 3.Department of Nuclear ScienceNational Tsing-Hua UniversityHsinchuTaiwan
  4. 4.Department of Public HealthTzu Chi UniversityHualienTaiwan
  5. 5.Graduate Institute of Epidemiology, College of Public HealthNational Taiwan University TaipeiTaipeiTaiwan
  6. 6.Genomics Research CenterAcademia SinicaTaipeiTaiwan

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