Municipal drinking water nitrate level and cancer risk in older women: The Iowa women's health study

Peter J. Weyer, James R Cerhan, Burton C. Kross, George R. Hallberg, Jiji Kantamneni, George Breuer, Michael P. Jones, Wei Zheng, Charles F. Lynch

Research output: Contribution to journalArticle

232 Citations (Scopus)

Abstract

Nitrate contamination of drinking water may increase cancer risk, because nitrate is endogenously reduced to nitrite and subsequent nitrosation reactions give rise to N-nitroso compounds; these compounds are highly carcinogenic and can act systemically. We analyzed cancer incidence in a cohort of 21,977 Iowa women who were 55-69 years of age at baseline in 1986 and had used the same water supply more than 10 years (87% > 20 years); 16,541 of these women were on a municipal supply, and the remainder used a private well. We assessed nitrate exposure from 1955 through 1988 using public databases for municipal water supplies in Iowa (quartile cutpoints: 0.36, 1.01, and 2.46 mg per liter nitrate-nitrogen). As no individual water consumption data were available, we assigned each woman an average level of exposure calculated on a community basis; no nitrate data were available for women using private wells. Cancer incidence (N = 3,150 cases) from 1986 through 1998 was determined by linkage to the Iowa Cancer Registry. For all cancers, there was no association with increasing nitrate in drinking water, nor were there clear and consistent associations for non-Hodgkin lymphoma; leukemia; melanoma; or cancers of the colon, breast, lung, pancreas, or kidney. There were positive associations for bladder cancer [relative risks (RRs) across nitrate quartiles = 1, 1.69, 1.10, and 2.83] and ovarian cancer (RR = 1, 1.52, 1.81, and 1.84), and inverse associations for uterine cancer (RR = 1, 0.86, 0.86, and 0.55) and rectal cancer (RR = 1, 0.72, 0.95, and 0.47) after adjustment for a variety of cancer risk/protective factors, agents that affect nitrosation (smoking, vitamin C, and vitamin E intake), dietary nitrate, and water source. Similar results were obtained when analyses were restricted to nitrate level in drinking water from 1955 through 1964. The positive association for bladder cancer is consistent with some previous data; the associations for ovarian, uterine, and rectal cancer were unexpected.

Original languageEnglish (US)
Pages (from-to)327-338
Number of pages12
JournalEpidemiology
Volume12
Issue number3
DOIs
StatePublished - 2001

Fingerprint

Women's Health
Drinking Water
Nitrates
Neoplasms
Nitrosation
Uterine Neoplasms
Water Supply
Rectal Neoplasms
Urinary Bladder Neoplasms
Ovarian Neoplasms
Nitroso Compounds
Protective Agents
Incidence
Nitrites
Vitamin E
Non-Hodgkin's Lymphoma
Colonic Neoplasms
Ascorbic Acid
Drinking
Registries

Keywords

  • Cohort study
  • Drinking water
  • Environmental exposures
  • Gender
  • N-nitroso compounds
  • Neoplasms
  • Water contaminants

ASJC Scopus subject areas

  • Epidemiology

Cite this

Weyer, P. J., Cerhan, J. R., Kross, B. C., Hallberg, G. R., Kantamneni, J., Breuer, G., ... Lynch, C. F. (2001). Municipal drinking water nitrate level and cancer risk in older women: The Iowa women's health study. Epidemiology, 12(3), 327-338. https://doi.org/10.1097/00001648-200105000-00013

Municipal drinking water nitrate level and cancer risk in older women : The Iowa women's health study. / Weyer, Peter J.; Cerhan, James R; Kross, Burton C.; Hallberg, George R.; Kantamneni, Jiji; Breuer, George; Jones, Michael P.; Zheng, Wei; Lynch, Charles F.

In: Epidemiology, Vol. 12, No. 3, 2001, p. 327-338.

Research output: Contribution to journalArticle

Weyer, PJ, Cerhan, JR, Kross, BC, Hallberg, GR, Kantamneni, J, Breuer, G, Jones, MP, Zheng, W & Lynch, CF 2001, 'Municipal drinking water nitrate level and cancer risk in older women: The Iowa women's health study', Epidemiology, vol. 12, no. 3, pp. 327-338. https://doi.org/10.1097/00001648-200105000-00013
Weyer, Peter J. ; Cerhan, James R ; Kross, Burton C. ; Hallberg, George R. ; Kantamneni, Jiji ; Breuer, George ; Jones, Michael P. ; Zheng, Wei ; Lynch, Charles F. / Municipal drinking water nitrate level and cancer risk in older women : The Iowa women's health study. In: Epidemiology. 2001 ; Vol. 12, No. 3. pp. 327-338.
@article{de9dc3eeec9d48f79f9f95ec823e6093,
title = "Municipal drinking water nitrate level and cancer risk in older women: The Iowa women's health study",
abstract = "Nitrate contamination of drinking water may increase cancer risk, because nitrate is endogenously reduced to nitrite and subsequent nitrosation reactions give rise to N-nitroso compounds; these compounds are highly carcinogenic and can act systemically. We analyzed cancer incidence in a cohort of 21,977 Iowa women who were 55-69 years of age at baseline in 1986 and had used the same water supply more than 10 years (87{\%} > 20 years); 16,541 of these women were on a municipal supply, and the remainder used a private well. We assessed nitrate exposure from 1955 through 1988 using public databases for municipal water supplies in Iowa (quartile cutpoints: 0.36, 1.01, and 2.46 mg per liter nitrate-nitrogen). As no individual water consumption data were available, we assigned each woman an average level of exposure calculated on a community basis; no nitrate data were available for women using private wells. Cancer incidence (N = 3,150 cases) from 1986 through 1998 was determined by linkage to the Iowa Cancer Registry. For all cancers, there was no association with increasing nitrate in drinking water, nor were there clear and consistent associations for non-Hodgkin lymphoma; leukemia; melanoma; or cancers of the colon, breast, lung, pancreas, or kidney. There were positive associations for bladder cancer [relative risks (RRs) across nitrate quartiles = 1, 1.69, 1.10, and 2.83] and ovarian cancer (RR = 1, 1.52, 1.81, and 1.84), and inverse associations for uterine cancer (RR = 1, 0.86, 0.86, and 0.55) and rectal cancer (RR = 1, 0.72, 0.95, and 0.47) after adjustment for a variety of cancer risk/protective factors, agents that affect nitrosation (smoking, vitamin C, and vitamin E intake), dietary nitrate, and water source. Similar results were obtained when analyses were restricted to nitrate level in drinking water from 1955 through 1964. The positive association for bladder cancer is consistent with some previous data; the associations for ovarian, uterine, and rectal cancer were unexpected.",
keywords = "Cohort study, Drinking water, Environmental exposures, Gender, N-nitroso compounds, Neoplasms, Water contaminants",
author = "Weyer, {Peter J.} and Cerhan, {James R} and Kross, {Burton C.} and Hallberg, {George R.} and Jiji Kantamneni and George Breuer and Jones, {Michael P.} and Wei Zheng and Lynch, {Charles F.}",
year = "2001",
doi = "10.1097/00001648-200105000-00013",
language = "English (US)",
volume = "12",
pages = "327--338",
journal = "Epidemiology",
issn = "1044-3983",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Municipal drinking water nitrate level and cancer risk in older women

T2 - The Iowa women's health study

AU - Weyer, Peter J.

AU - Cerhan, James R

AU - Kross, Burton C.

AU - Hallberg, George R.

AU - Kantamneni, Jiji

AU - Breuer, George

AU - Jones, Michael P.

AU - Zheng, Wei

AU - Lynch, Charles F.

PY - 2001

Y1 - 2001

N2 - Nitrate contamination of drinking water may increase cancer risk, because nitrate is endogenously reduced to nitrite and subsequent nitrosation reactions give rise to N-nitroso compounds; these compounds are highly carcinogenic and can act systemically. We analyzed cancer incidence in a cohort of 21,977 Iowa women who were 55-69 years of age at baseline in 1986 and had used the same water supply more than 10 years (87% > 20 years); 16,541 of these women were on a municipal supply, and the remainder used a private well. We assessed nitrate exposure from 1955 through 1988 using public databases for municipal water supplies in Iowa (quartile cutpoints: 0.36, 1.01, and 2.46 mg per liter nitrate-nitrogen). As no individual water consumption data were available, we assigned each woman an average level of exposure calculated on a community basis; no nitrate data were available for women using private wells. Cancer incidence (N = 3,150 cases) from 1986 through 1998 was determined by linkage to the Iowa Cancer Registry. For all cancers, there was no association with increasing nitrate in drinking water, nor were there clear and consistent associations for non-Hodgkin lymphoma; leukemia; melanoma; or cancers of the colon, breast, lung, pancreas, or kidney. There were positive associations for bladder cancer [relative risks (RRs) across nitrate quartiles = 1, 1.69, 1.10, and 2.83] and ovarian cancer (RR = 1, 1.52, 1.81, and 1.84), and inverse associations for uterine cancer (RR = 1, 0.86, 0.86, and 0.55) and rectal cancer (RR = 1, 0.72, 0.95, and 0.47) after adjustment for a variety of cancer risk/protective factors, agents that affect nitrosation (smoking, vitamin C, and vitamin E intake), dietary nitrate, and water source. Similar results were obtained when analyses were restricted to nitrate level in drinking water from 1955 through 1964. The positive association for bladder cancer is consistent with some previous data; the associations for ovarian, uterine, and rectal cancer were unexpected.

AB - Nitrate contamination of drinking water may increase cancer risk, because nitrate is endogenously reduced to nitrite and subsequent nitrosation reactions give rise to N-nitroso compounds; these compounds are highly carcinogenic and can act systemically. We analyzed cancer incidence in a cohort of 21,977 Iowa women who were 55-69 years of age at baseline in 1986 and had used the same water supply more than 10 years (87% > 20 years); 16,541 of these women were on a municipal supply, and the remainder used a private well. We assessed nitrate exposure from 1955 through 1988 using public databases for municipal water supplies in Iowa (quartile cutpoints: 0.36, 1.01, and 2.46 mg per liter nitrate-nitrogen). As no individual water consumption data were available, we assigned each woman an average level of exposure calculated on a community basis; no nitrate data were available for women using private wells. Cancer incidence (N = 3,150 cases) from 1986 through 1998 was determined by linkage to the Iowa Cancer Registry. For all cancers, there was no association with increasing nitrate in drinking water, nor were there clear and consistent associations for non-Hodgkin lymphoma; leukemia; melanoma; or cancers of the colon, breast, lung, pancreas, or kidney. There were positive associations for bladder cancer [relative risks (RRs) across nitrate quartiles = 1, 1.69, 1.10, and 2.83] and ovarian cancer (RR = 1, 1.52, 1.81, and 1.84), and inverse associations for uterine cancer (RR = 1, 0.86, 0.86, and 0.55) and rectal cancer (RR = 1, 0.72, 0.95, and 0.47) after adjustment for a variety of cancer risk/protective factors, agents that affect nitrosation (smoking, vitamin C, and vitamin E intake), dietary nitrate, and water source. Similar results were obtained when analyses were restricted to nitrate level in drinking water from 1955 through 1964. The positive association for bladder cancer is consistent with some previous data; the associations for ovarian, uterine, and rectal cancer were unexpected.

KW - Cohort study

KW - Drinking water

KW - Environmental exposures

KW - Gender

KW - N-nitroso compounds

KW - Neoplasms

KW - Water contaminants

UR - http://www.scopus.com/inward/record.url?scp=0035059254&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035059254&partnerID=8YFLogxK

U2 - 10.1097/00001648-200105000-00013

DO - 10.1097/00001648-200105000-00013

M3 - Article

C2 - 11338313

AN - SCOPUS:0035059254

VL - 12

SP - 327

EP - 338

JO - Epidemiology

JF - Epidemiology

SN - 1044-3983

IS - 3

ER -