Drinking Water Disinfection Byproducts and Uterine Cancer—A Modifiable Environmental Exposure Hiding in Plain Sight
Menée à partir de données de la cohorte californienne "California Teachers Study" portant sur 53 100 femmes (âge médian : 50 ans), cette étude analyse l'association entre une exposition aux sous-produits de désinfection et aux contaminants inorganiques présents dans l'eau potable et le risque de cancer de l'utérus
In this issue of JAMA Network Open, Spaur and colleagues report a prospective analysis of regulated drinking water contaminants and uterine cancer risk in the California Teachers Study, a cohort of 53 100 residentially stable female educators followed for nearly 2 decades. Among 1038 incident cases of uterine cancer, 15-year mean exposures to total trihalomethanes (TTHMs) at the residence were associated with an 18% higher risk in the highest tertile compared with the lowest (HR, 1.18; 95% CI, 1.02-1.38), with a stronger signal for endometrioid tumors (HR, 1.23; 95% CI, 1.05-1.46). Chloroform and dibromochloromethane were the leading individual contributors, and a quantile-based g-computation mixture analysis was directionally concordant, although the overall estimate was imprecise (HR per IQR increase, 1.21; 95% CI, 0.96-1.53). Total haloacetic acids (HAA5), although limited by sparse historical data, were associated with nonendometrioid tumors (HR, 1.86; 95% CI, 1.06-3.25). No associations were observed for arsenic, uranium, or nitrate. These findings establish drinking water disinfection byproducts (DBPs) as plausible, modifiable contributors to a malignancy whose incidence and mortality are rising in the US and globally.
JAMA Network Open , éditorial en libre accès, 2026