Contaminated drinking water is associated with increased risk of uterine cancer

1. In a large cohort study, an increased risk of uterine cancer was found in women with enrollment addresses linked to a community water supply with known tap water contamination, with the highest risks associated with trihalomethanes and haloacetic acids exposure, and little to no risk associated with nitrate, arsenic, or uranium levels.

Evidence Rating Level: 2 (Good)

Uterine cancer is the most diagnosed gynecologic cancer, where almost 95% of all uterine cancer cases consists of endometrial cancer. Tap water remains a major source of exposure to carcinogenic contaminants in many communities. This cohort study evaluated 53100 women who lived in a known jurisdiction with contaminated tap water for 10 years or longer. Incident uterine cancers were identified through the California cancer registry. Higher levels of trihalomethanes in tap water were associated with higher risk of uterine cancer, with hazards ratio (HR) = 1.18 (95% CI 1.02-1.38, P=0.06), specifically with endometrial tumours (HR=1.23, 95% CI 1.05-1.46, p=0.01). High levels of haloacetic acids in tap water were also associated with higher risk of uterine cancer, but with nonendometriod tumours (HR=1.86, 95% CI 1.06-3.25, p=0.01). No associations were observed with levels of nitrate, arsenic, or uranium in tap water. Overall, this study provides evidence that greater exposure to trihalomethanes and haloacetic acids in drinking water is associated with an increased risk of uterine cancer. These findings underscore the public health importance of monitoring drinking water for these contaminants and implementing strategies to reduce exposure across communities.

Click here to read this study in JAMA Network Open

Image: PD

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