The aim of the study was to assess upper tract urothelial carcinoma (UTUC) health care needs and specific mortality rates in an arsenic-exposed region in Northern Chile and compare them to those of the rest of the country.
Arsenic levels of drinking water were correlated with UTUC hospital discharges and cancer-specific mortality rates. Mortality and hospital admission rate ratios were estimated using a Poisson regression model.
There were 257 UTUC-specific deaths in Chile between 1990 and 2016; 81 (34%) of them occurred in Antofagasta, where only 3.5% of the population lives. The peak mortality rate observed in Antofagasta was 2.15/100,000 compared to 0.07/100,000 in the rest of the country. Mortality in the exposed region was significantly higher when compared to the rest of the country (MRR 17.6; 95%CI: 13.5-22.9). The same trend was observed for UTUC hospital discharges (RR 14.8; 95%CI: 11.5-19.1).
Even stronger than for bladder cancer, exposure to arsenic is related to a significant need for UTUC health care and high mortality rates, even 25 years after having controlled arsenic levels in drinking-water. Awareness of this ecologic factor in these affected regions is therefore mandatory.
Urologic oncology. 2020 Feb 19 [Epub ahead of print]
José Francisco López, Mario I Fernández, Luis Fernando Coz
Department of Urology, Hospital de La Florida, Santiago, Chile., Department of Urology, Clínica Alemana de Santiago,Santiago, Chile; Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. Electronic address: ., Department of Urology, Hospital Militar de Santiago, Santiago, Chile; Faculty of Medicine, Universidad de Los Andes, Santiago, Chile.