Javier García-Pérez1, Nerea Fernández de Larrea-Baz2, Virginia Lope3, Antonio J Molina4, Cristina O'Callaghan-Gordo5, María Henar Alonso6, Marta María Rodríguez-Suárez7, Benito Mirón-Pozo8, Juan Alguacil9, Inés Gómez-Acebo10, Nieves Ascunce11, Mercedes Vanaclocha-Espi12, Pilar Amiano13, María Dolores Chirlaque14, Vicente Simó15, José J Jiménez-Moleón16, Adonina Tardón17, Víctor Moreno18, Gemma Castaño-Vinyals19, Vicente Martín20, Nuria Aragonés21, Beatriz Pérez-Gómez22, Manolis Kogevinas23, Marina Pollán24. 1. Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain. Electronic address: jgarcia@isciii.es. 2. Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain. Electronic address: nfernandez@isciii.es. 3. Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain. Electronic address: vicarvajal@isciii.es. 4. The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institute of Biomedicine (IBIOMED), Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain. Electronic address: ajmolt@unileon.es. 5. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla de Poblenou 156, 08018 Barcelona, Spain; Institute of Global Health (ISGlobal), Carrer del Rosselló 132, 08036 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Campus del Mar, Carrer del Dr. Aiguader 80, 08003 Barcelona, Spain. Electronic address: cristina.ocallaghan@isglobal.org. 6. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Hospital Duran i Reynals, Avinguda de la Gran Via de l'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Avinguda de la Gran Via de l'Hospitalet 199, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Carrer de Casanova 143, 08036 Barcelona, Spain. Electronic address: mhalonso@iconcologia.net. 7. Hospital Universitario Central de Asturias (HUCA), Av. Roma s/n, 33011 Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Public Health Department, Universidad de Oviedo, 33003 Oviedo, Spain. 8. Service of Surgery, Hospital Universitario Clínico San Cecilio, Av. del Conocimiento s/n, 18016 Granada, Spain. Electronic address: benito.miron.sspa@juntadeandalucia.es. 9. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071 Huelva, Spain. Electronic address: alguacil@dbasp.uhu.es. 10. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Universidad de Cantabria - IDIVAL, Avenida Cardenal Herrera Oria s/n, 39011 Santander, Spain. Electronic address: ines.gomez@unican.es. 11. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Navarra Public Health Institute, Calle Leyre, 15, 31003 Pamplona, Navarra; IdiSNA, Navarra Institute for Health Research, Calle Leyre 15, 31003 Pamplona, Spain. Electronic address: nieves.ascunce.elizaga@navarra.es. 12. Cancer and Public Health Area, FISABIO - Public Health, Avda. de Catalunya 21, 46020 Valencia, Spain. Electronic address: vanaclocha_mer@gva.es. 13. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Ministry of Health of the Basque Government, Paseo Dr. Beguiristain s/n, 20014 San Sebastian, Spain. Electronic address: epicss-san@euskadi.eus. 14. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Campus de Ciencias de la Salud, Carretera Buenavista s/n, 30120 El Palmar, Murcia, Spain. Electronic address: mdolores.chirlaque@carm.es. 15. Department of General Surgery, León University Hospital (CAULE), Altos de Nava s/n, 24071 León, Spain. Electronic address: vsimo@saludcastillayleon.es. 16. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Av. de la Investigación 11, 18016 Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Doctor Azpitarte 4 4ª Planta, Edificio Licinio de la Fuente, 18012 Granada, Spain. Electronic address: jjmoleon@ugr.es. 17. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Instituto Universitario de Oncología (IUOPA), Universidad de Oviedo, Facultad de Medicina, Campus de El Cristo B, 33006 Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. Roma s/n, 33011 Oviedo, Spain. Electronic address: atardon@uniovi.es. 18. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Hospital Duran i Reynals, Avinguda de la Gran Via de l'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Avinguda de la Gran Via de l'Hospitalet 199, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Carrer de Casanova 143, 08036 Barcelona, Spain. Electronic address: v.moreno@iconcologia.net. 19. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Institute of Global Health (ISGlobal), Carrer del Rosselló 132, 08036 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Campus del Mar, Carrer del Dr. Aiguader 80, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Dr. Aiguader 88, 08003 Barcelona, Spain. Electronic address: gemma.castano@isglobal.org. 20. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institute of Biomedicine (IBIOMED), Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain. Electronic address: vmars@unileon.es. 21. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, C/San Martín de Porres, 6, 28035 Madrid, Spain. Electronic address: nuria.aragones@salud.madrid.org. 22. Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain. Electronic address: bperez@isciii.es. 23. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Institute of Global Health (ISGlobal), Carrer del Rosselló 132, 08036 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Campus del Mar, Carrer del Dr. Aiguader 80, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Dr. Aiguader 88, 08003 Barcelona, Spain. Electronic address: manolis.kogevinas@isglobal.org. 24. Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain. Electronic address: mpollan@isciii.es.
Abstract
BACKGROUND: Colorectal cancer is the third most frequent tumor in males and the second in females worldwide. In Spain, it is an important and growing health problem, and epidemiologic research focused on potential risk factors, such as environmental exposures, is necessary. OBJECTIVES: To analyze the association between colorectal cancer risk and residential proximity to industries, according to pollution discharge route, industrial groups, categories of carcinogens and other toxic substances, and specific pollutants released, in the context of a population-based multicase-control study of incident cancer carried out in Spain (MCC-Spain). METHODS: MCC-Spain included 557 colorectal cancer cases and 2948 controls in 11 provinces, frequency matched by sex, age, and region of residence. Distances were computed from subjects' residences to each of the 134 industries located in the study area. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1 km to 3 km) to industrial facilities, adjusting for matching variables and other confounders. RESULTS: Excess risk (OR; 95%CI) of colorectal cancer was detected near industries overall for all distances analyzed, from 1 km (2.03; 1.44-2.87) to 3 km (1.26; 1.00-1.59). In general, industries releasing pollutants to air showed higher excess risks than facilities releasing pollution to water. By industrial sector, excess risk (OR; 95%CI) was found near (≤3 km) production of metals (2.66; 1.77-4.00), surface treatment of metals (1.48; 1.08-2.02), glass and mineral fibers (2.06; 1.39-3.07), organic chemical industry (4.80; 3.20-7.20), inorganic chemical industry (6.74; 4.38-10.36), food/beverage sector (3.34; 2.38-4.68), and surface treatment using organic solvents (6.16; 4.06-9.36). By pollutants, the main excess risks (OR; 95%CI) were found near (≤3 km) industries releasing nonylphenol (9.19; 5.91-14.28), antimony (5.30; 3.45-8.15), naphthalene (3.11; 2.16-4.49), organotin compounds (2.64; 1.76-3.98), manganese (2.53; 1.63-3.93), dichloromethane (2.52; 1.74-3.66), and vanadium (2.49; 1.59-3.91). CONCLUSIONS: Our results support the hypothesis that residing in the proximity of industries may be a risk factor for colorectal cancer.
BACKGROUND:Colorectal cancer is the third most frequent tumor in males and the second in females worldwide. In Spain, it is an important and growing health problem, and epidemiologic research focused on potential risk factors, such as environmental exposures, is necessary. OBJECTIVES: To analyze the association between colorectal cancer risk and residential proximity to industries, according to pollution discharge route, industrial groups, categories of carcinogens and other toxic substances, and specific pollutants released, in the context of a population-based multicase-control study of incident cancer carried out in Spain (MCC-Spain). METHODS: MCC-Spain included 557 colorectal cancer cases and 2948 controls in 11 provinces, frequency matched by sex, age, and region of residence. Distances were computed from subjects' residences to each of the 134 industries located in the study area. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1 km to 3 km) to industrial facilities, adjusting for matching variables and other confounders. RESULTS: Excess risk (OR; 95%CI) of colorectal cancer was detected near industries overall for all distances analyzed, from 1 km (2.03; 1.44-2.87) to 3 km (1.26; 1.00-1.59). In general, industries releasing pollutants to air showed higher excess risks than facilities releasing pollution to water. By industrial sector, excess risk (OR; 95%CI) was found near (≤3 km) production of metals (2.66; 1.77-4.00), surface treatment of metals (1.48; 1.08-2.02), glass and mineral fibers (2.06; 1.39-3.07), organic chemical industry (4.80; 3.20-7.20), inorganic chemical industry (6.74; 4.38-10.36), food/beverage sector (3.34; 2.38-4.68), and surface treatment using organic solvents (6.16; 4.06-9.36). By pollutants, the main excess risks (OR; 95%CI) were found near (≤3 km) industries releasing nonylphenol (9.19; 5.91-14.28), antimony (5.30; 3.45-8.15), naphthalene (3.11; 2.16-4.49), organotin compounds (2.64; 1.76-3.98), manganese (2.53; 1.63-3.93), dichloromethane (2.52; 1.74-3.66), and vanadium (2.49; 1.59-3.91). CONCLUSIONS: Our results support the hypothesis that residing in the proximity of industries may be a risk factor for colorectal cancer.