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Front Oncol. 2018 Jun 29;8:242. doi: 10.3389/fonc.2018.00242. eCollection 2018.

Urinary Lead Concentration Is an Independent Predictor of Cancer Mortality in the U.S. General Population.

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School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.
Department of Physiology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong.
Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China.
Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, GA, United States.


Lead is a ubiquitous pollutant that constitutes an environmental hazard worldwide. Although lead has been known as a carcinogenic factor in animal models, its role in human carcinogenesis is still a topic of debate with limited epidemiological evidence. Moreover, the association between urinary lead, as the most non-invasive and accessible way for lead measurement in human, and cancer mortality in general population has never been explored. We addressed this subject using continuous National Health and Nutrition Examination Survey 1999-2010 data and its Mortality Follow-Up Study. Of 5,316 subjects in study population, 161 participants died due to cancer. Cancer-specific mortality was associated with urinary lead levels after multivariable adjustment. Kaplan-Meier survival curve and cubic regression spline analyses indicated that high concentration of urinary lead exhibited significant association with raised death rate of cancer. Despite the marked decrease in environmental lead levels over the past three decades, lead exposure is still the significant determinant of cancer mortality in general population in U.S., and quantification of urinary lead may serve as a non-invasive approach to facilitate biomarker discovery and clinical translational research.


National Health and Nutrition Examination Survey; biomarker; cancer mortality; epidemiology; urinary lead

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