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<p>The role of multiple elements in esophageal cancer (EC) remains unclear, especially in low-level metal exposure area. To investigate the causal relationship between elements and EC risk, we conducted a case–cohort study nested within the Taizhou Longitudinal Study, in which the baseline fasting serum concentrations of 21 elements in a subcohort of 926 randomly selected subjects and 256 participants with incident EC were measured. Baseline urine levels of four arsenic species were also measured among 826 subcohort subjects and 232 EC cases to further elucidate the potential impact of arsenic on EC risk. Cox proportional hazards regression was used to estimate adjusted hazard ratios for EC associated with elements and false discovery rate (FDR) correction was performed for multiple testing. The results indicated that elevated serum level of arsenic was associated with a reduced risk of EC, with a p-value for trend of 0.002 after FDR correction. When analyzing urinary arsenic species, we found urinary dimethylarsinic acid (DMA) was weakly correlated with serum arsenic. DMA was inversely associated with EC risk after excluding the first two years of follow-up and showed a significant interaction with smoking. Overall, this case–cohort study did not suggest positive associations between any of serum elements examined and EC risk. Nevertheless, the inverse associations of serum arsenic and urinary DMA with EC risk should be interpreted cautiously. Further population-based and experimental studies that incorporate metabolome and consider multiple biomarkers of exposure are required.</p>

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Association of Serum Elements and Urinary Arsenic Species with Esophageal Cancer Risk in a Low Metal Exposure Area: A Case–Cohort Study in China

  • 期刊论文

  • 发表日期：

    2026年2月1日

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  • Qingling Su,
  • Zesen Gao,
  • Yan Wu,
  • Yang Ouyang,
  • Shanshan Du,
  • Hongwei Zhao,
  • Weidong Qu,
  • Yanfeng Jiang,
  • Chen Suo,
  • Ziyu Yuan,
  • Xingdong Chen,
  • Ruimei Feng,
  • Weimin Ye

摘要

The role of multiple elements in esophageal cancer (EC) remains unclear, especially in low-level metal exposure area. To investigate the causal relationship between elements and EC risk, we conducted a case–cohort study nested within the Taizhou Longitudinal Study, in which the baseline fasting serum concentrations of 21 elements in a subcohort of 926 randomly selected subjects and 256 participants with incident EC were measured. Baseline urine levels of four arsenic species were also measured among 826 subcohort subjects and 232 EC cases to further elucidate the potential impact of arsenic on EC risk. Cox proportional hazards regression was used to estimate adjusted hazard ratios for EC associated with elements and false discovery rate (FDR) correction was performed for multiple testing. The results indicated that elevated serum level of arsenic was associated with a reduced risk of EC, with a p-value for trend of 0.002 after FDR correction. When analyzing urinary arsenic species, we found urinary dimethylarsinic acid (DMA) was weakly correlated with serum arsenic. DMA was inversely associated with EC risk after excluding the first two years of follow-up and showed a significant interaction with smoking. Overall, this case–cohort study did not suggest positive associations between any of serum elements examined and EC risk. Nevertheless, the inverse associations of serum arsenic and urinary DMA with EC risk should be interpreted cautiously. Further population-based and experimental studies that incorporate metabolome and consider multiple biomarkers of exposure are required.