Abstract
BackgroundWe sought to identify high-risk areas of pancreatic cancer incidence, and determine if clusters of persons diagnosed with pancreatic cancer were more likely to be located near arsenic-contaminated drinking water wells.MethodsA total of 5,707 arsenic samples were collected from December 2000 to May 2008 by the Florida Department of Health, representing more than 5,000 individual privately owned wells. During that period, 0.010 ppm (10 ppb) or greater arsenic levels in private well water were considered as the threshold based on standard of United States Environmental Protection Agency (EPA). Spatial modeling was applied to pancreatic cancer cases diagnosed between 1998–2002 in Florida (n = 11,405). Multivariable logistic regression was used to determine if sociodemographic indicators, smoking history, and proximity to arsenic-contaminated well sites were associated with residence at the time of pancreatic cancer diagnosis occurring within versus outside a cluster.ResultsSpatial modeling identified 16 clusters in which 22.6% of all pancreatic cancer cases were located. Cases living within 1 mile of known arsenic-contaminated wells were significantly more likely to be diagnosed within a cluster of pancreatic cancers relative to cases living more than 3 miles from known sites (odds ratio = 2.1 [95% CI = 1.9, 2.4]).ConclusionsExposure to arsenic-contaminated drinking water wells may be associated with an increased risk of pancreatic cancer. However, case–control studies are needed in order to confirm the findings of this ecological analysis. These cluster areas may be appropriate to evaluate pancreatic cancer risk factors, and to perform targeted screening and prevention studies.
Highlights
We sought to identify high-risk areas of pancreatic cancer incidence, and determine if clusters of persons diagnosed with pancreatic cancer were more likely to be located near arsenic-contaminated drinking water wells
We sought to ascertain if there were any pancreatic cancer clusters in Florida, and to identify socio-demographic and behavioral correlates associated with these clusters. Controlling for these factors, we explored if pancreatic cancer cluster membership was associated with proximity to identified arsenic-contaminated drinking water wells
Cases living within 1 mile of known arseniccontaminated wells were significantly more likely to be diagnosed within a cluster of pancreatic cancers relative to cases living more than 3 miles from known sites (OR = 2.1; 95% confidence intervals (CI) = 1.9- 2.4); on the other hand, compared to cases
Summary
We sought to identify high-risk areas of pancreatic cancer incidence, and determine if clusters of persons diagnosed with pancreatic cancer were more likely to be located near arsenic-contaminated drinking water wells. The American Cancer Society estimated that 43,140 persons in the US would be diagnosed with pancreatic cancer in 2010, and that 94% of the patients will die from this highly lethal malignancy [1]. Each year 250,000 people worldwide will die of pancreatic cancer [2]. People who use smokeless (spit or chew) tobacco are more likely to develop pancreatic cancer. In an addition to cigarette smoking, consistent evidence of a positive association has been found between family history and pancreatic cancer. With the exception of tobacco smoking and family history, other risk factors for pancreatic cancer have not been well-established
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