Asset Publisher



Risk of colorectal and breast cancer with widespread drinking water chemical contaminants

Cancer-Watch Project
Photo: Imani at Unsplash / ISGlobal
13/11/2019 - 31/12/2022
Cristina Villanueva
Funded by
French Agency for Food, Environmental and Occupational Health & Safety (ANSES)

Breast and colorectal cancer rank first and third most incident cancers worldwide. Part of the burden of disease remains unexplained by the known etiological factors and some chemicals in drinking water have been suggested as risk factors.

Nitrate and disinfection by-products (DBPs) are widespread in drinking water. Nitrate originates from fertilizers used in intensive agriculture and waste from intensive farms. DPBs form a complex mixture generated in the drinking water treatment as unwanted by-products from disinfection. Trihalomethanes (THMs) are prevalent chlorination-DBPs used as a surrogate of DBP exposure in epidemiological studies. Alternative disinfectants (e.g. ozonation, chlorine dioxide) produce other DBPs (e.g. bromate, chlorite, chlorate). All of us are exposed to THMs through ingestion, inhalation or dermal absorption in showers or baths, as THMs are volatile and skin permeable.

Long-term exposure to nitrate and THMs at levels below the regulatory limits has been linked to colorectal and breast cancer. However, current knowledge is inconclusive, particularly concerning the co-exposure to nitrate and multiple DBPs.

We propose the first evaluation based on a large French population-based prospective cohort (CONSTANCES), including 200,000 subjects from areas with wide exposure variation.

Cancer-Watch aims to provide new epidemiological evidence on the association between DBPs and nitrate in drinking water with breast and colorectal cancer risk. Specifically, we will:

  • 1) Ascertain drinking water source and treatment in the study areas for 1950-2019.
  • 2) Model level of THMs, bromate, chlorate, chlorite, and nitrate in drinking water.
  • 3) Validate current routine monitoring data with own measurements.
  • 4) Estimate long-term exposure to THM, bromate, chlorite, chlorate and nitrate in the study population.
  • 5) Evaluate the breast and colorectal cancer risk associated with long-term exposure to THMs, bromate, chlorate, chlorite, and nitrate, adjusting for confounders.

Cancer-Watch is a collaborative project led by ISGlobal in collaboration with INSERM U1085 (Dr. Bénédicte Jacquemin, Barbara Le Bot, Philippe Glorennec) and INSERM UMS011 (Marcel Goldberg, Marie Zins.)

Cancer-Watch will contribute to elucidate the role of widespread drinking water chemicals on the risk of highly frequent cancers in the population, thus providing relevant evidence for health risk assessment and regulation with enormous potential to reduce the burden of disease.

Total Funding

199,996 €

Our Team

Project Coordinator

ISGlobal Team

Other projects

See Past Projects


Population based multicasecontrol study on common tumours in Spain


Novel tools for integrating early-life environmental exposures and child health across Europe


Early Genetics Growth/Early Genetics and Lifecourse Epidemiology


Pregnancy and Childhood Epigenetics


Early-life stressors and LifeCycle health


Network on the Coordination and Harmonisation of European Occupational Cohorts


Health effects of cArdiac fluoRoscopy and mOdern radIotherapy in paediatriCs


Connecting digital mobility assessment to clinical outcomes for regulatory and clinical endorsement


Signs of Early Adaptation to Climate Change


Cohorte Covid-19 en Cataluña


Advancing Tools for Human Early Lifecourse Exposome Research and Translation


Cohort of COVID-19 in Spain: social dynamics, mental health and inequalities


A federated FAIR platform enabling large-scale analysis of high-value cohort data connecting Europe and Canada in personalized health


An integrative strategy of testing systems for identification of EDs related to metabolic disorders


EXposome Powered tools for healthy living in urbAN SEttings


Actionable eUropean ROadmap for early-life health Risk Assessment of micro- and nanoplastics


Fine Particle Matter, Fetal Growth, and Neurodevelopment: Examining Critical Windows of Susceptibility


Pre-natal exposure to urban AIR pollution and pre- and post-Natal Brain development


The role of seafood and nut consumption on human neurodevelopment from pregnancy to adolescence


Urban and social environment and childhood obesity – a natural moving2health experiment


In-Depth Genomics and Cross-Omics Analysis for Undiagnosed Rare Diseases on a User-Friendly Collaborative Platform


An Exposome Approach to Urban Health: Individualized Environmental Exposure Assessment in an Adults Population Cohort Study (GCAT)


Digital Twins Enabled Indoor Air Quality Management for Healthy Living


The Urban Burden of Disease Estimation for POLICY Making


Combining Artificial Intelligence and smart sensing TOward better management and improved quality of LIFE in chronic obstructive pulmonary disease


Drinking Water in Barcelona: Sustainability and Health Impact Assessment


Innovative Tools to Control Organic Matter and Disinfection Byproducts in Drinking Water


FTIR spectroscopy for real-time detection of bacterial outbreaks and the rapid identification of pathogenic serotypes, relapsing infections and antibiotic resistance


Occupational exposure to radiofrequency electromagnetic fields: From exposure assessment to study of health in workers and their offspring


Exposome Project for Health and Occupational Research


Analysing and studying how night shift work affects workers' circadian rhythms and health


International Human Exposome Network


Una prueba en el punto de atención para la estratificación del riesgo de los pacientes febriles basada en los niveles de sTREM-1


e-health tools to promote Equality in Quality of Life for childhood to young adulthood cancer patients, survivors and their families