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Nitrate in public water supplies and the risk of colon and rectum cancers
Journal article   Open access   Peer reviewed

Nitrate in public water supplies and the risk of colon and rectum cancers

Anneclaire J De Roos, Mary H Ward, Charles F Lynch and Kenneth P Cantor
Epidemiology (Cambridge, Mass.), v 14(6), pp 640-649
Nov 2003
PMID: 14569178
url
https://journals.lww.com/epidem/Fulltext/2003/11000/Nitrate_in_Public_Water_Supplies_and_the_Risk_of.4.aspxView
Published, Version of Record (VoR) Open

Abstract

Adult Aged Aged, 80 and over Colonic Neoplasms - chemically induced Colonic Neoplasms - epidemiology Female Humans Male Middle Aged Nitrates - poisoning Rectal Neoplasms - chemically induced Rectal Neoplasms - epidemiology Risk Factors United States - epidemiology Water Pollution Water Supply - analysis
Nitrate is a widespread contaminant of drinking water, but its potential health effects are unclear. In the body, nitrate is reduced to nitrite, which can react with amines and amides by nitrosation to form N-nitroso compounds, known animal carcinogens. N-nitroso compound formation is inhibited by certain nutrients, such as vitamin C, and increased by meat intake. We investigated the association of nitrate in public water supplies with incident colon and rectum cancers in a case-control study conducted in Iowa from 1986 to 1989. Nitrate levels in Iowa towns were linked to the participants' water source histories. We focused our analyses on the period from 1960 onward, during which nitrate measurements were more frequent, and we restricted analyses to those persons with public water supplies that had nitrate data (actual or imputed) for greater than 70% of this time period (376 colon cancer cases, 338 rectum cancer cases, and 1244 controls). There were negligible overall associations of colon or rectum cancers with measures of nitrate in public water supplies, including average nitrate and the number of years with elevated average nitrate levels. For more than 10 years with average nitrate greater than 5 mg/L, the odds ratio (OR) for colon cancer was 1.2 (95% confidence interval [CI] = 0.9-1.6) and for rectum the OR was 1.1 (CI = 0.7-1.5). However, nitrate exposure (>10 years with average nitrate >5 mg/L) was associated with increased colon cancer risk among subgroups with low vitamin C intake (OR = 2.0; CI = 1.2-3.3) and high meat intake (OR = 2.2; CI = 1.4-3.6). These patterns were not observed for rectum cancer. Our analyses suggest that any increased risk of colon cancer associated with nitrate in public water supplies might occur only among susceptible subpopulations.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#14 Life Below Water
#3 Good Health and Well-Being
#6 Clean Water and Sanitation

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Collaboration types
Domestic collaboration
Web of Science research areas
Public, Environmental & Occupational Health
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