Cause-specific mortality and cancer incidence rates in relation to urinary β2-microglobulin: 23-Year follow-up study in a cadmium-polluted area

Abstract A longitudinal study was performed to investigate the associations of exposure to environmental cadmium (Cd) with cause-specific mortality and cancer incidence rates. The study population comprised 275 adults living in a Cd-polluted area, Nagasaki Prefecture, Japan. The follow-up period extended from 1982 to 2005 for the analysis of cancer mortality, and from 1985 to 2002 for the analysis of cancer incidence. In the study area, the daily Cd intake from foods had decreased after 1980–1983 because of the restoration of Cd-polluted rice fields. The mortality rate among those with urinary β2-microglobulin (U-β2M) ≥ 1000 μg/g creatinine was significantly higher than that of the Japanese population for death from causes other than cancer, but not for cancers (177 at the 95% confidence interval [CI] 94–303). From analysis within the Cd-polluted area, the age-adjusted rate ratio of cancer deaths associated with increased U-β2M was 2.58 (95% CI 1.25–5.36). The incidence rate of cancer among those with U-β2M ≥ 1000 μg/g creatinine was 1.38 (95% CI 0.69–2.47) times that of the regional reference rate. Within the Cd-polluted area, the age-adjusted rate ratio of developing cancer associated with high U-β2M was 1.79 (95% CI 0.84–3.82). In summary, there was a significant association between U-β2M excretion and cancer mortality. However, there was neither a significantly increased standardized incidence ratio of cancer, nor significant relationship between U-β2M and cancer incidence rate, though the point estimates were higher than unity. Continued follow-up and investigation of a larger cohort may be required before drawing a conclusion for the association between exposure to environmental Cd and cancer risk.