Arsenic exposure is associated with significant upper tract urothelial carcinoma health care needs and elevated mortality rates.

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.

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