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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

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Lifetime Swimming Pool Attendance and Cancer Risk: Findings from the Multicase-Control Study in Spain (MCC-Spain).

Carolina Donat-Vargas^1,2,3,4,5, Miquel Vallbona-Vistós^1,6, Gemma Castaño-Vinyals^1,4,6,7

¹ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain.

Environmental Science & Technology

|November 3, 2025

Summary

Swimming in pools may lower breast and colorectal cancer risk, despite potential carcinogen exposure. Regular swimming, especially year-round, shows a protective association for these common cancers.

Keywords:

Disinfection byproducts breast cancer case-control study colorectal cancer environmental epidemiology observational study prostate cancer swimming pool

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Area of Science:

Epidemiology
Environmental Health
Oncology

Background:

Swimming pools expose individuals to disinfection byproducts (DBPs), which may be carcinogenic.
Physical activity from swimming offers protective benefits against certain cancers.
The dual nature of pool swimming (DBP exposure vs. physical activity) necessitates investigating its net effect on cancer risk.

Purpose of the Study:

To evaluate the association between lifetime swimming pool attendance and the risk of breast, colorectal, and prostate cancer.
To differentiate the impact of indoor (year-round) versus outdoor (summer) pool attendance on cancer risk.
To assess cancer risk in relation to swimming frequency.

Main Methods:

A multicase-control study in Spain (2008-2013) involving 4,941 cancer cases and 4,039 controls.
Face-to-face interviews collected data on lifetime pool attendance (summer/year-round), socio-demographics, and lifestyle.
Linear mixed-effect models were used to estimate cancer risk, adjusting for covariates and using recruitment area as a random effect.

Main Results:

Lifetime pool attendance was associated with approximately 5% lower odds of breast and colorectal cancer.
Pool attendance outside summer months (indoor pools) was linked to reduced breast and colorectal cancer risk.
Increased prostate cancer risk was associated with pool attendance outside summer months.

Conclusions:

Lifetime swimming in pools may offer a protective effect against breast and colorectal cancer, even with potential disinfection byproduct exposure.
Year-round swimming appears more protective for breast and colorectal cancers than summer-only swimming.
Further research is needed to replicate these findings on swimming and cancer risk.