Association between urinary arsenic, blood cadmium, blood lead, and blood mercury levels and serum prostate-specific antigen in a population-based cohort of men in the United States

PLoS One. 2021 Apr 23;16(4):e0250744. doi: 10.1371/journal.pone.0250744. eCollection 2021.

Abstract

Exposures to heavy metals have been linked to prostate cancer risk. The relationship of these exposures with serum prostate-specific antigen (PSA), a marker used for prostate cancer screening, is unknown. We examined whether total urinary arsenic, urinary dimethylarsonic acid, blood cadmium, blood lead, and total blood mercury levels are associated with elevated PSA among presumably healthy U.S. men. Prostate cancer-free men, aged ≥40 years, were identified from the 2003-2010 National Health and Nutrition Examination Survey. Logistic regression analyses with survey sample weights were used to examine the association between heavy metal levels and elevated PSA for the total population and stratified by black and white race, after adjusting for confounders. There were 5,477 men included. Approximately 7% had elevated PSA. Men with an elevated PSA had statistically significantly higher levels of blood cadmium and blood lead compared to men with a normal PSA (p-values ≤ 0.02), with black men having higher levels. After adjusting for age, race/ethnicity, body mass index, smoking, and education, there was no association found between any of the heavy metal levels and elevated PSA for the total population. In addition, there was no association found when stratified by black and white race. Further investigation is warranted in a larger cohort of men who persistently are exposed to these heavy metals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arsenic / urine*
  • Black or African American
  • Cadmium / blood*
  • Cohort Studies
  • Humans
  • Lead / blood*
  • Logistic Models
  • Male
  • Mercury / blood*
  • Middle Aged
  • Nutrition Surveys
  • Odds Ratio
  • Prostate-Specific Antigen / blood*
  • United States
  • White People

Substances

  • Cadmium
  • Lead
  • Prostate-Specific Antigen
  • Mercury
  • Arsenic

Grants and funding

The study was funded by Highmark Foundation’s Human Health and the Environment Seed Grant Program at The Pennsylvania State University (ACM & MW). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.