Colorectal cancer risk and nitrate exposure through drinking water and diet

Espejo Herrera, Nadia Carminia, 1983-; Gràcia Lavedan, Esther; Castaño Vinyals, Gemma; Basagaña Flores, Xavier; Nieuwenhuijsen, Mark J.; Kogevinas, Manolis; Villanueva Belmonte, Cristina

Colorectal cancer risk and nitrate exposure through drinking water and diet

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dc.contributor.author Espejo Herrera, Nadia Carminia, 1983-ca
dc.contributor.author Gràcia Lavedan, Estherca
dc.contributor.author Castaño Vinyals, Gemmaca
dc.contributor.author Basagaña Flores, Xavierca
dc.contributor.author Nieuwenhuijsen, Mark J.ca
dc.contributor.author Kogevinas, Manolisca
dc.contributor.author Villanueva Belmonte, Cristinaca
dc.date.accessioned 2016-05-20T17:47:17Z
dc.date.issued 2016
dc.description.abstract Ingested nitrate leads to the endogenous synthesis of N-nitroso compounds (NOCs), animal carcinogens with limited human evidence. We aimed to evaluate the risk of colorectal cancer (CRC) associated with nitrate exposure in drinking water and diet. A case-control study in Spain and Italy during 2008-2013 was conducted. Hospital-based incident cases and population-based (Spain) or hospital-based (Italy) controls were interviewed on residential history, water consumption since age 18, and dietary information. Long-term waterborne ingested nitrate was derived from routine monitoring records, linked to subjects' residential histories and water consumption habits. Dietary nitrate intake was estimated from food frequency questionnaires and published food composition databases. Odd ratios (OR) were calculated using mixed models with area as random effect, adjusted for CRC risk factors and other covariables. Generalized additive models (GAMs) were used to analyze exposure-response relationships. Interaction with endogenous nitrosation factors and other covariables was also evaluated. In total 1,869 cases and 3,530 controls were analyzed. Average waterborne ingested nitrate ranged from 3.4 to 19.7 mg/day, among areas. OR (95% CIs) of CRC was 1.49 (1.24, 1.78) for >10 versus ≤5 mg/day, overall. Associations were larger among men versus women, and among subjects with high red meat intake. GAMs showed increasing exposure-response relationship among men. Animal-derived dietary nitrate was associated with rectal, but not with colon cancer risk. In conclusion, a positive association between CRC risk and waterborne ingested nitrate is suggested, mainly among subgroups with other risk factors. Heterogeneous effects of nitrate from different sources (water, animal and vegetables) warrant further research.ca
dc.description.sponsorship This study was funded by the “Acción Transversal del Cáncer del Consejo de Ministros del 11/10/2007”, from the “Instituto de Salud Carlos III-FEDER” (PI08/1770, PI08/0533, PI11/00226), ISCIII FIS grants, and HIWATE-EU project (036224). NEH receives funding for the PhD program in Biomedicine from the “Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR FI-DGR 2013) Generalitat de Cataluña”
dc.format.mimetype application/pdfca
dc.identifier.citation Espejo-Herrera N, Gràcia-Lavedan E, Boldo E, Aragonés N, Pérez-Gómez B, Pollán M et al. Colorectal cancer risk and nitrate exposure through drinking water and diet. International journal of cancer. 2016;139(2):334-46. DOI: 10.1002/ijc.30083ca
dc.identifier.doi http://dx.doi.org/10.1002/ijc.30083
dc.identifier.issn 0020-7136
dc.identifier.uri http://hdl.handle.net/10230/26312
dc.language.iso engca
dc.publisher Wileyca
dc.relation.ispartof International journal of cancer. 2016;139(2):334-46
dc.rights This is the pre-peer reviewed version of the following article: Espejo-Herrera N, Gràcia-Lavedan E, Boldo E, Aragonés N, Pérez-Gómez B, Pollán M et al. Colorectal cancer risk and nitrate exposure through drinking water and diet. International journal of cancer. 2016; 139(2): 334-346. DOI 10.1002/ijc.30083, which has been published in final form at http://dx.doi.org/10.1002/ijc.30083. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.ca
dc.rights.accessRights info:eu-repo/semantics/openAccessca
dc.subject.keyword Case-control studies
dc.subject.keyword Colorectal cancer
dc.subject.keyword Diet
dc.subject.keyword Drinking water
dc.subject.keyword Nitrate
dc.subject.other Nitratsca
dc.subject.other Recte -- Càncerca
dc.title Colorectal cancer risk and nitrate exposure through drinking water and dietca
dc.type info:eu-repo/semantics/articleca
dc.type.version info:eu-repo/semantics/acceptedVersionca

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