Association between air cadmium exposure and prostate cancer aggressiveness at diagnosis

Abstract

Introduction There is clear evidence that high levels of occupational exposure to cadmium (Cd) lead to a more aggressive prostate cancer (PC) tumor. At levels of exposure which are more relevant to the general population, there is disputing evidence as to whether Cd causes a PC tumor to become more aggressive. In this study, we assess the relationship between ambient exposure to air Cd and PC stage at diagnosis. Methods We collected outcome data from the Surveillance, Epidemiology, and End Results (SEER) for reported PC cases diagnosed from 2010 to 2014. PC stage at diagnosis was categorized as metastatic or localized. Exposure data was collected from the 2011 National Air Toxics Assessment (NATA) which was developed by the EPA to review air toxics in the United States. The total exposure concentration of Cd compounds in the air was a county‐level metric calculated by the EPA using weighted averages of air Cd concentration levels measured at various point emission sources. We calculated quintiles of Cd exposure concentration for ease of interpretation. Odds Ratios (OR) and 95% confidence intervals (CI) assessing the relationship between county‐level air Cd exposure and PC stage at diagnosis were calculated using multivariable logistic regression models. Analyses were adjusted for age at diagnosis, sociodemographic status, and overall air quality and were stratified by race. Results The study cohort consisted of 234,991 PC cases from 594 counties reported by SEER. Of these cases, 92.5% were localized and 7.5% metastatic at diagnosis. Higher levels of air Cd exposure were associated with an increased likelihood of a PC case being metastatic at diagnosis. The adjusted odds ratios for the 80th percentile vs 20th percentile of Cd exposure were: all races (OR 1.030, CI 1.019 – 1.040), White (1.049, CI 1.037 – 1.062), Black (1.032, CI 1.0072 – 1.057), and other races (0.965, CI 0.925 – 1.0062). Conclusion Higher Cd air exposure concentration was associated with advanced PC stage at diagnosis with effects that vary somewhat by race. Since inhalation of Cd in the air only contributes to a small percentage of total Cd intake, further studies should be conducted to investigate the effects of other forms of Cd intake such as dietary and water exposures on PC aggressiveness. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.