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Water-Related Exposures and Bladder Cancer Risk: A Comprehensive Epidemiologic Review.

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Water quality and hydration impact bladder cancer risk. Contaminants like arsenic and disinfection by-products (DBPs) increase risk, while adequate fluid intake offers protection, highlighting modifiable factors for prevention.

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Area of Science:

  • Environmental health
  • Oncology
  • Epidemiology

Background:

  • Bladder cancer is a significant global health concern.
  • Environmental factors, especially water contaminants, are increasingly implicated.
  • Water's dual role as a contaminant carrier and protective fluid is under investigation.

Purpose of the Study:

  • To review the epidemiological evidence on water-related exposures and bladder cancer risk.
  • To evaluate the role of specific contaminants (arsenic, DBPs, nitrates, PFAS) and fluid intake.
  • To synthesize findings on biological plausibility and public health relevance.

Main Methods:

  • Comprehensive synthesis of epidemiological studies.
  • Focus on major water-related exposures and total fluid intake.
  • Evaluation based on strength of association, biological plausibility, and public health relevance.

Main Results:

  • Arsenic and disinfection by-products (DBPs) show consistent links to increased bladder cancer risk.
  • Associations with nitrates and per- and polyfluoroalkyl substances (PFAS) are less consistent.
  • Higher water consumption demonstrates a protective effect, potentially via carcinogen dilution and increased voiding.

Conclusions:

  • Drinking-water quality is a modifiable determinant of bladder cancer.
  • Regulatory actions and behavioral strategies (e.g., hydration) can aid prevention.
  • Further research is needed for emerging contaminants and global water safety policies.