ArticleJournal of the National Cancer Institute2026
Drinking water nitrate, disinfection byproducts, and prostate cancer incidence in the Agricultural Health Study.
Maya Spaur, Stella Koutros, Lauren M Hurwitz, Cherrel K Manley, Jared A Fisher, Samantha Ammons, Jessica M Madrigal, Dazhe Chen, Christine G Parks, Paul S Albert and 5 more
Abstract read
In one paragraphArticle in Journal of the National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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What it found
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5 · Who and what moneyAuthors and funding
15 authors.
Maya SpaurOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0002-4578-5513 Stella KoutrosOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0001-5294-5485 Lauren M HurwitzOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0001-8932-5028 Cherrel K ManleyDepartment of Epidemiology, University of North Carolina Chapel Hill Gillings School of Public Health, Chapel Hill, NC, United States.ORCID 0000-0002-5795-1216 Jared A FisherOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.
Samantha AmmonsOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0002-7902-128X Jessica M MadrigalOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0001-5303-5109 Dazhe ChenEpidemiology Branch, Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, United States.ORCID 0000-0001-9951-5458 Christine G ParksEpidemiology Branch, Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, United States.ORCID 0000-0002-5734-3456 Paul S AlbertBiostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0003-1658-1068 Dale P SandlerEpidemiology Branch, Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, United States.ORCID 0000-0002-6776-0018 Jonathan N HofmannOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0002-1043-5812 Laura E Beane FreemanOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0003-1294-4124 Rena R JonesOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0003-1294-1679 Mary H WardOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.ORCID 0000-0001-7584-8856 Funding
STUDIES OF OCCUPATIONAL CANCER--PESTICIDESZ01CP010119 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI ALAVANJA, MICHAEL · 1996 to 2008
$5.0MHEALTH EFFECTS OF EXPOSURES IN AGRICULTUREZ01ES049030 · NIEHS · NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES · PI SANDLER, DALE P · 1997 to 2008
$889kHHSIntramural NIH HHS Z01 CP010119Intramural NIH HHS Z01 ES049030Intramural NIH HHS Z99 CA999999Intramural Research Programs of the National Institutes of Health (NIH), the National Cancer Institute Z01-CP010119NCI NIH HHS Z01-CP010119NIEHS NIH HHS Z01-ES049030NIHNIH HHSNIOSH CDC HHS T42 OH008673NIOSH CDC HHS T42-OH008673Works of the United States Government
6 · The paper itselfAbstract
backgroundDrinking water can be an important source of exposure to nitrate and disinfection by-products, including trihalomethanes (THMs) and haloacetic acids (HAAs). N-nitroso compounds formed endogenously after nitrate ingestion are animal carcinogens, and THM and HAA exposures increase the risk of some cancers. Our objectives were to evaluate associations of drinking water nitrate and disinfection byproducts with total and aggressive (distant stage, poorly differentiated grade, fatal, or Gleason score ≥7) prostate cancer in the Agricultural Health Study cohort.
methodsMale participants who were cancer free and used private wells or public water supplies (PWS) for drinking water at enrollment (1993-1997, n = 40 403) were followed through 2021 (mean = 21.9 years). Average nitrate-nitrogen (nitrate-N) concentrations were estimated for private well users based on state-specific geologic and meteorologic factors. We used monitoring data to compute average nitrate-N, THMs, and HAAs for PWS users. We estimated hazard ratios (HRs, 95% CIs) per doubling and categories of exposure for total (n = 3625) and aggressive (n = 2200) prostate cancer using Cox proportional hazards regression.
resultsMedian (interquartile range) average water nitrate-N was 1.49 (0.76-3.01) mg L-1; 6% >10 mg L-1 (PWS maximum contaminant level). Compared to nitrate-N ≤ 1 mg L-1, exposures >10 mg L-1 were significantly positively associated with total (1.16, 1.01-1.35; P = .10 for trend) and aggressive disease (1.22, 1.02-1.47; P = .03 for trend). We observed weak associations between higher nitrate-N (Q4 vs Q1) and total (1.05, 0.95-1.16) and aggressive (1.13, 0.99-1.27) disease. We did not observe associations with total THMs or HAAs.
conclusionsThese findings suggest that drinking water nitrate-N exposure, at average levels > 10 mg L-1, is a risk factor for prostate cancer, particularly aggressive disease.
Indexed as
DisinfectantsDrinking WaterNitratesProstatic NeoplasmsWater Pollutants, ChemicalAcetatesAdultAgedAgricultureDisinfectionHumansIncidenceMaleMiddle AgedTrihalomethanesUnited StatesAcetatesDisinfectantsDrinking WaterNitratesTrihalomethanesWater Pollutants, Chemical
Identifiers
PMID41423865
PMCPMC12832043
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