RE: Elevated Bladder Cancer in Northern New England: The Role of Drinking Water and Arsenic

In a large, population-based case–control study in New England, we recently reported a positive exposure-response relationship between cumulative arsenic intake from drinking water and bladder cancer risk (odds ratio [OR] for quartile 4 vs quartile 1 = 1.32, 95% confidence interval [CI] = 1.02 to 1.72; OR = 1.37, 95% CI = 1.03 to 1.82, for exposure lagged 40 years) (Supplementary Table 1Supplementary Table 1, available online) (1). The mechanism by which arsenic induces bladder cancer is not well understood, although several studies have suggested arsenic may target important tumor-suppresser genes (p16, Rb) and disrupt cell cycle control (2). Here, we show heterogeneity in the arsenic–bladder cancer risk relationship by tumor expression of these cell cycle proteins.

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