Influence of the Levels of Arsenic, Cadmium, Mercury and Lead on Overall Survival in Lung Cancer.

Sandra Pietrzak,Janusz Wójcik,Darko Gajić,Tomasz Grodzki,Marcin R Lener,Piotr Baszuk,Bartłomiej Masojć,Rodney J Scott,Tadeusz Dębniak,Jacek Gronwald,Jan Lubiński,Cezary Cybulski,Piotr Waloszczyk,Anna Jakubowska,Jacek Alchimowicz,Małgorzata Wojtyś,Wojciech Marciniak

doi:10.3390/biom11081160

Abstract

The effects of heavy metals on cancer risk have been widely studied in recent decades, but there is limited data on the effects of these elements on cancer survival. In this research, we examined whether blood concentrations of the heavy metals arsenic, cadmium, mercury and lead were associated with the overall survival of lung cancer patients. The study group consisted of 336 patients with lung cancer who were prospectively observed. Blood concentrations of heavy metals were measured to study the relationship between their levels and overall survival using Cox proportional hazards analysis. The hazard ratio of death from all causes was 0.99 (p = 0.94) for arsenic, 1.37 (p = 0.15) for cadmium, 1.55 (p = 0.04) for mercury, and 1.18 (p = 0.47) for lead in patients from the lowest concentration quartile, compared with those in the highest quartile. Among the patients with stage IA disease, this relationship was statistically significant (HR = 7.36; p < 0.01) for cadmium levels in the highest quartile (>1.97–7.77 µg/L) compared to quartile I (0.23–0.57 µg/L, reference). This study revealed that low blood cadmium levels <1.47 µg/L are probably associated with improved overall survival in treated patients with stage IA disease.

Highlights

9.6 million people die from cancer every year and lung cancer remains the leading cause of cancer death
The aim of this study was to determine whether concentrations of heavy metals such as As, Cd, Hg and Pb have any influence on the overall survival in lung cancer patients
We modelled the relationship between blood heavy metal levels on overall survival using a Cox proportional hazards analysis

Summary

Introduction

9.6 million people die from cancer every year and lung cancer remains the leading cause of cancer death. Death from lung cancer affects over 1.7 million people annually, which represents 18.4% of the total cancer deaths [1] Heavy metals such as cadmium, lead, arsenic and mercury play an important carcinogenic role, especially for lung cancer [2,3] 4.0/). Registry (ATSDR), which ranks substances based on a combination of their frequency, toxicity and potential human exposure, includes the four elements we have examined in this study, i.e., arsenic being ranked first on the list, lead second, mercury third and cadmium seventh [4]. Sources of exposure to As may be from the air, drinking water and food This element is a known carcinogen, regardless of whether the exposure occurs through inhalation or ingestion [7]

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