Riesgo de cáncer en España por carcinógenos en el agua de consumo

Duration

2012-2014

Coordinator

Cristina Villanueva

Funded by

FIS

Cancer of the colon and rectum, breast and prostate are among the most frequent malignancies in developed countries, and chronic lymphocytic leukaemia (CLL) is the most common form of leukaemia. Many aetiological factors have been identified, but part of the burden of disease remains unexplained. Environmental exposures, including carcinogens in drinking water, could partly be responsible for this unexplained fraction. However, evidence from observational studies is unclear given the difficulties to assess the long-term exposure.

OBJECTIVES: We aim to evaluate the involvement of chronic exposure to drinking water carcinogens (disinfection by-products, nitrate, metals and pesticides) on increasing the risk of colorectal, breast, prostate cancer and CLL, based on a robust exposure assessment.

METHODS: A multi case-control study (MCC-Sp) is conducted in 11 Spanish provinces (Asturias, Barcelona, Cantabria, Gipuzkoa, Granada, Huelva, León, Madrid, Murcia, Navarra and Valencia), using a common protocol. Expected study population includes 2000 colorectal, 1500 breast, 1000 prostate cancer and 500 CLL cases and 3000 controls by the end of 2011. Personal information on water consumption in all the residences since age 18yrs and data on risk factors is collected through a personal interview in all study subjects. Biological samples are collected and molecular markers of early effect (DNA methylation, n-nitroso adducts) and internal dose (urine trichloroacetic acid) will be measured in a subset. Lifetime exposure to disinfection by-products, nitrate, metals and pesticides will be accurately evaluated based on environmental levels and personal behaviour. The risk of cancer and molecular markers associated with the aetiologically relevant water contaminants will be estimated.