Case-control study of arsenic in drinking water and kidney cancer in uniquely exposed Northern Chile

Catterina Ferreccio, Allan H. Smith, Viviana Durán, Teresa Barlaro, Hugo Benítez, Rodrigo Valdés, Juan José Aguirre, Lee E. Moore, Johanna Acevedo, María Isabel Vásquez, Liliana Pérez, Yan Yuan, Jane Liaw, Kenneth P. Cantor, Craig Steinmaus

Research output: Contribution to journalArticlepeer-review

101 Scopus citations


Millions of people worldwide are exposed to arsenic in drinking water. The International Agency for Research on Cancer has concluded that ingested arsenic causes lung, bladder, and skin cancer. However, a similar conclusion was not made for kidney cancer because of a lack of research with individual data on exposure and dose-response. With its unusual geology, high exposures, and good information on past arsenic water concentrations, northern Chile is one of the best places in the world to investigate the carcinogenicity of arsenic. We performed a case-control study in 2007-2010 of 122 kidney cancer cases and 640 population-based controls with individual data on exposure and potential confounders. Cases included 76 renal cell, 24 transitional cell renal pelvis and ureter, and 22 other kidney cancers. For renal pelvis and ureter cancers, the adjusted odds ratios by average arsenic intakes of <400, 400-1,000, and >1,000 μg/day (median water concentrations of 60, 300, and 860 μg/L) were 1.00, 5.71 (95% confidence interval: 1.65, 19.82), and 11.09 (95% confidence interval: 3.60, 34.16) (Ptrend < 0.001), respectively. Odds ratios were not elevated for renal cell cancer. With these new findings, including evidence of dose-response, we believe there is now sufficient evidence in humans that drinking-water arsenic causes renal pelvis and ureter cancer.

Original languageEnglish
Pages (from-to)813-818
Number of pages6
JournalAmerican Journal of Epidemiology
Issue number5
StatePublished - 1 Sep 2013
Externally publishedYes


  • Chile
  • arsenic
  • case-control
  • drinking water
  • kidney cancer


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