association of arsenic exposure with lung cancer incidence rates in the united states协会砷暴露与肺癌的发病率在美国.pdf

Association of Arsenic Exposure with Lung Cancer Incidence Rates in the United States Joseph J. Putila1,2, Nancy Lan Guo1,2* 1 Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, West Virginia, United States of America, 2 Department of Community Medicine, West Virginia University, Morgantown, West Virginia, United States of America Abstract Background: Although strong exposure to arsenic has been shown to be carcinogenic, its contribution to lung cancer incidence in the United States is not well characterized. We sought to determine if the low-level exposures to arsenic seen in the U.S. are associated with lung cancer incidence after controlling for possible confounders, and to assess the interaction with smoking behavior. Methodology: Measurements of arsenic stream sediment and soil concentration obtained from the USGS National Geochemical Survey were combined, respectively, with 2008 BRFSS estimates on smoking prevalence and 2000 U.S. Census county level income to determine the effects of these factors on lung cancer incidence, as estimated from respective state- wide cancer registries and the SEER database. Poisson regression was used to determine the association between each variable and age-adjusted county-level lung cancer incidence. ANOVA was used to assess interaction effects between covariates. Principal Findings: Sediment levels of arsenic were significantly associated with an increase in incident cases of lung cancer (P,0.0001). These effects persisted after controlling for smoking and income (P,0.0001). Across the U.S., exposure to arsenic may contribute to up to 5,297 lung cancer cases per year. There was also a significant interaction between arsenic exposure levels and smoking prevalence (P,0.05). Conclusions/Significance: Arsenic was significantly associated with