Elevated Bladder Cancer in Northern New England: The Role of Drinking Water and Arsenic

Introduction: Bladder cancer mortality rates have been elevated in northern New England for at least five decades. Incidence rates in Maine, New Hampshire and Vermont are about 20% higher than the United States overall. We explored reasons for this excess, focusing on arsenic in drinking water from private wells, which are particularly prevalent in the region. Methods: In a population-based case-control study in these three states, 1,213 bladder cancer cases and 1,418 controls provided information on suspected risk factors. Arsenic concentrations were estimated by modeling based on measurements in water samples from current and past homes. Results: Bladder cancer risk increased with increasing water intake (P-trend=0.003). This trend was statistically significant among participants with a history of private well use (P-trend=0.01). Among private well users, this trend was apparent if well water was derived exclusively from shallow dug wells (which are vulnerable to contamination from manmade sources) (P-t...