Hexavalent chromium and bladder cancer risk

Stamatiou, K.

doi:10.1016/j.acuroe.2011.06.020

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Breda, O. Rodríguez Faba, E. Espejo, J.M. Cozar, H. Villavicencio" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Breda" ] 1 => array:2 [ "nombre" => "O." "apellidos" => "Rodríguez Faba" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Espejo" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Cozar" ] 4 => array:2 [ "nombre" => "H." 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Stamatiou" "autores" => array:1 [ 0 => array:3 [ "nombre" => "K." "apellidos" => "Stamatiou" "email" => array:1 [ 0 => "stamatiouk@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Stamatiou Departamento de Cirugía y Urología, Hospital General de Tebas, Tebas, Greece" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Como hexavalente y riesgo de cáncer de vejiga" ] ] "textoCompleto" => "We have recently completed a study on the follow-up of patients with superficial bladder carcinoma. This controlled prospective study took place at the General Hospital of Thebes (Viotia, Greece) from April 2006 to February 2009. More precisely, the study group included a total of 45 patients who had a recent history of recurrent superficial bladder cancer and subsequent TUR-BTs. Upon the completion of the study we realized that the 42% recurrence rate observed in our sample is unusually high, given that it actually represents the recurrences in the time between two cystoscopies. The reasons explaining this finding are practically unknown. It could be hypothesized that it may be due to the relatively large number of high risk bladder cancer patients (no. 7). Another reason explaining the high recurrence rate could be the fact that all the patients are from the cities of Thiva, Inofyta and Schimatari, (Thiva-Tanagra-Malakasa basin, Eastern Sterea Ellada, Greece), which support many industrial activities. According to our investigations, all the subjects with a confirmed bladder cancer recurrence consume tap water. Concentrations of chromium (up to 80mg/L Cr(VI)) have recently been found in the urban water supply of Inofyta city. Cr(VI) concentrations ranging from 5 to 33mg/L were found in groundwater that is used for Thiva's water supply. Arsenic concentrations up to 34mg/L along with Cr(VI) levels up to 40mg/L were detected in Schimatari's water supply.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Hexavalent chromium is a potent carcinogen and previous studies have shown that it causes lung cancer in humans in certain occupational settings as a result of inhalation exposure.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> So far as we know, carcinogen exposure via consumption of drinking water has been investigated previously and is potentially of importance. In fact, the use of drinking water contaminated by nitrate, hexavalent chromium, and other heavy metals from industrial discharges has been associated with carcinogenesis,<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a> and a large American study has found that drinking more fluids is associated with a significantly decreased rate of bladder cancer.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Interestingly, a more focused experimental study demonstrated that hexavalent chromium can cause bladder cancer in animals when administered orally.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> The specific mechanism remains unclear; however, it might be associated to tap water concentrations of heavy metals. This urogenous-contact hypothesis could play a role in Greece since the warm climate favors dehydration which itself increases the urine concentration.Actually, an older epidemiologic study in the above region demonstrated that cancer mortality in this area is 14% higher than in other areas of Viotia, the prefecture in which it is located. Alarmingly, it also showed that the incidence of cancer fatalities had increased by 90% in 2009 alone, and deaths from cancer of the urinal tract are 841% higher than similar fatalities elsewhere in Viotia.<a class="elsevierStyleCrossRef" href="#bib0035">7</a>Against a background of increased knowledge and interest in bladder cancer specific pathophysiology, our knowledge on epidemiology and risk factors is still limited and the exact genetic events leading to the development of bladder cancer remain unknown. According to the current knowledge, cigarette smoking and occupational exposure have been recognized as risk factors<a class="elsevierStyleCrossRefs" href="#bib0040">8,9</a> while cyclophosphamide treatment and urothelial trauma have been -only- proposed to be.<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a> The only well established carcinogens are alpha- and beta-naphthylamine, benzidine, and 4-aminobiphenyl.Currently, it is not known whether hexavalent chromium promotes bladder cancer development and if the drinking of contaminated water is linked to its recurrence. However, there is no doubt about the urgent need for a better understanding of the early phase/initiation of bladder cancer in view of all the potential carcinogenic substances in order to decrease the high prevalence of the disease. Epidemiologic investigations should consider the complex pathogenesis of bladder cancer and the fact that many patients are in contact with multiple potential carcinogenic agents. Ideally, this would require a prospective multicenter data collection/analysis based on a standardized database including a strict defined patient cohort with detailed patients history and a long follow-up.Considering the abovementioned study regarding the overall cancer prevalence in the cities of Thiva, Inofyta and Schimatari, we do believe that epidemiologic studies are also necessary to assess the prevalence of bladder cancer in the region above." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Stamatiou K. Como hexavalente y riesgo de cancer de vejiga. Como hexavalente y riesgo de cáncer de vejiga. 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Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided. It has high visibility and accessibility and is found in the most important data bases, Medline/Pubmed, Emabase, JCR, Ïndice Médico Español, Índice bibliográfico Español en Ciencias de la Salud (IBECS), Cuiden, Dialnet, Hinari, Scopus, Google Scholar.

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SJR 2023

0.332

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

0.557

View more metrics

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Vol. 36. Issue 3.

Pages 199-200 (March 2012)

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