Colorectal cancer risk and nitrate exposure through drinking water and diet
Nadia Espejo-Herrera, Esther Gràcia-Lavedan, Elena Boldo, Nuria Aragonés, Beatriz Pérez-Gómez, Marina Pollán, Antonio J. Molina, Tania Fernández, Vicente Martín, Carlo La Vecchia, Cristina Bosetti, Alessandra Tavani, Jerry Polesel, Diego Serraino, Inés Gómez Acebo, Jone M. Altzibar, Eva Ardanaz, Rosana Burgui, Federica Pisa, Guillermo Fernández-Tardón, Adonina Tardón, Rosana Peiró, Carmen Navarro, Gemma Castaño-Vinyals, Victor Moreno, Elena Righi, Gabriella Aggazzotti, Xavier Basagaña, Mark Nieuwenhuijsen, Manolis Kogevinas and Cristina M. Villanueva
Article first published online: 4 APR 2016 | DOI: 10.1002/ijc.30083
Nitrate ingested in food and water can react with amines and amides in the gastrointestinal tract, leading to the formation of N-nitroso compounds (NOCs), which are carcinogenic in animals. In humans, nitrate and several NOCs are probable carcinogens. The aim of the present investigation, a case–control study in Europe, was to examine links between nitrate intake and colorectal cancer (CRC). The findings indicate that CRC risk is increased for waterborne nitrate intake at levels below current international guidelines, particularly in subgroups with other risk factors. Nitrate intake from animal sources was further associated with increased rectal cancer risk.