Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 24, 2024; 15(11): 1454-1458
Published online Nov 24, 2024. doi: 10.5306/wjco.v15.i11.1454
Well water contaminants and colorectal cancer in North Dakota
Amber D Lyon-Colbert, Marc D Basson, Marilyn G Klug, Gary G Schwartz
Amber D Lyon-Colbert, Department of Population Health, University of North Dakota, Grand Forks, ND 58202, United States
Marc D Basson, College of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, United States
Marc D Basson, College of Medicine, University Hospitals, Cleveland, OH 44106, United States
Marilyn G Klug, Gary G Schwartz, Department of Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58202, United States
Co-corresponding authors: Amber D Lyon-Colbert and Gary G Schwartz.
Author contributions: Lyon-Colbert AD wrote the original draft; Basson MD and Klug MG participated in drafting the manuscript; Schwartz GG contributed to conceptualization, reviewing and editing; all authors have read and approved the final version of the manuscript.
Supported by The National Institute of General Medical Sciences (NIGMS), No. 1P20GM155890-01 to GGS.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amber D Lyon-Colbert, MS, PhD, Assistant Professor, Department of Population Health, University of North Dakota, 1301 N Columbia Road, Grand Forks, ND 58202, United States. amber.lyon@und.edu
Received: May 23, 2024
Revised: September 16, 2024
Accepted: September 25, 2024
Published online: November 24, 2024
Processing time: 143 Days and 13 Hours
Abstract

This study aims to identify common contaminants in well water linked to an increase in colorectal cancer (CRC) incidence rates in North Dakota (ND) counties. County-specific incidence rates for CRC were obtained from the ND Statewide Cancer Registry. Corresponding demographic, agricultural, and geophysical data were obtained from population-based sources. Associations between well water contaminants and CRC incidence were examined for 16 counties in ND with complete well water profiles between 1997-2019. Data were analyzed by multiple linear regression. Iron in well water exhibited a significant positive association with CRC incidence (4.75, P = 0.001), and barium exhibited a small, but significant negative association (-0.06907, P = 0.01). Residents in counties in ND with prevalent well water usage contaminated with iron may be at higher risk for CRC.

Keywords: Colorectal cancer; Iron; Water quality; Well water; North Dakota

Core Tip: The goal of this study was to investigate the association between colorectal cancer (CRC) incidence and chemicals commonly found in well water. The most important finding from this ecologic study is that iron in well water is significantly associated with CRC incidence across 16 counties in the state of North Dakota. These findings are broadly consistent with epidemiologic and experimental studies on the effects of iron in CRC carcinogenesis. Exploration into the implications of excess iron exposure and colorectal carcinogenesis may facilitate preventive interventions in rural and agricultural areas that rely heavily on well water as a drinking water source.