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Bladder cancer mortality and private well use in New England: an ecological study
  1. Joseph D Ayotte1,
  2. Dalsu Baris2,
  3. Kenneth P Cantor2,
  4. Joanne Colt2,
  5. Gilpin R Robinson, Jr3,
  6. Jay H Lubin2,
  7. Margaret Karagas4,
  8. Robert N Hoover2,
  9. Joseph F Fraumeni, Jr2,
  10. Debra T Silverman2
  1. 1US Geological Survey, New Hampshire-Vermont Water Science Center, Pembroke, New Hampshire, USA
  2. 2Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
  3. 3US Geological Survey, National Center, Reston, Virginia, USA
  4. 4Dartmouth College School of Medicine, Lebanon, New Hampshire, USA
  1. Correspondence to:
 Dr K P Cantor
 Division of Cancer Epidemiology and Genetics, NCI, 6120 Executive Blvd EPS-8106, Rockville, MD 20892-7240, USA; cantork{at}


Study objective: To investigate the possible relation between bladder cancer mortality among white men and women and private water use in New England, USA, where rates have been persistently raised and use of private water supplies (wells) common.

Design: Ecological study relating age adjusted cancer mortality rates for white men and women during 1985–1999 and proportion of persons using private water supplies in 1970. After regressing mortality rates on population density, Pearson correlation coefficients were computed between residual rates and the proportion of the population using private water supplies, using the state economic area as the unit of calculation. Calculations were conducted within each of 10 US regions.

Setting: The 504 state economic areas of the contiguous United States.

Participants: Mortality analysis of 11 cancer sites, with the focus on bladder cancer.

Main results: After adjusting for the effect of population density, there was a statistically significant positive correlation between residual bladder cancer mortality rates and private water supply use among both men and women in New England (men, r = 0.42; women, r = 0.48) and New York/New Jersey (men, r = 0.49; women, r = 0.62).

Conclusions: Use of well water from private sources, or a close correlate, may be an explanatory variable for the excess bladder cancer mortality in New England. Analytical studies are underway to clarify the relation between suspected water contaminants, particularly arsenic, and raised bladder cancer rates in northern New England.

  • bladder cancer
  • drinking water
  • private water supply
  • New England

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  • Funding: this research was supported in part by the Intramural Research Program of the NIH, National Cancer Institute, Division of Cancer Epidemiology and Genetics.

  • Conflicts of interest: none declared.

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