Arsenic Exposure and Haematological Derangement in Cervical Cancer Cases in India

Abstract

Cervical cancer is the second most common gynecological malignancy worldwide. According to HPV Information Centre, Spain (Aug'2014), in India approximately 1,22,844 women are diagnosed with the disease every year and of them 67,477 die due to the disease. CaCx is said to be mediated by HPV but recent data published reveal the role of Oxidative Stress in different Cancers. Arsenic is also one of the agents for causing Oxidative Stress. Arsenic has been linked with different types of cancer. Arsenic is considered responsible for generation of free radicals and eventually for apoptosis. Early diagnosis of CaCx is presently a matter of concern and clinical presentation in advanced stages become difficult for complete clinical response. For determination of oxidative stress, Malondialdehyde (MDA) was taken as an identifier and arsenic estimation was performed with the help of Atomic Absorption Spectrometer (AAS). RBC count and Haemoglobin levels were performed according to standard protocol. MDA was in direct proportion with arsenic concentration and inversely proportional to RBC and Haemoglobin in CaCx patients. Arsenic is one of the major causative agents for oxidative stress and hence may be a risk factor leading to cancer including CaCx.

Histopathology of Cervical Cancer and Arsenic Concentration in Well Water: An Ecological Analysis

“…The results reported here, together perhaps with that of Kumar et al [ 6 ], suggest that high concentrations of arsenic are biologically active in the development of squamous cell cancer of the cervix, and as such would warrant systematic investigation. Given the limited data on both HPV infection and on the proportion of cervical cancer cases with such infection in Bangladesh, a large-scale trial to assess the efficacy of screening in areas with both high and low arsenic concentration in well water, with urinary arsenic measurement and HPV characterization in cases and referents, would contribute greatly to knowledge of cervical cancer causality and management in Bangladesh and of the role of arsenic in its evolution.…”

“…There are essentially no data against which to compare the results of the current study. The only paper identified that addressed the relation between arsenic in drinking water and cervical cancer (in women in Patna, India) reported that mean blood arsenic concentration was higher, at 100.7 ppb, in 51 cervical cancer patients than in 48 healthy referents (arsenic concentration not given) [ 6 ]. The IARC reviews in 2004 [ 1 ] and 2008 [ 2 ] included only one study that had cervical cancer as an endpoint, with six deaths [ 5 ].…”

“…Although the number was too small to reach any conclusion, they reported an increase in standardized mortality ratio with higher arsenic exposures. One study from India investigated the relation between arsenic exposure and oxidative stress (as reflected in malondialderhyde (MDA)) in cervical cancer cases and referents and reported higher levels of arsenic and MDA in cases [ 6 ]. In Bangladesh, a high proportion of the population is exposed to arsenic in drinking water, with 27% of hand-pumped tube wells tested by the British Geological Survey, commissioned by the People’s Republic of Bangladesh, found to have arsenic concentration >50 μg/L [ 7 ].…”

“…In the human epidemiology of arsenic and cancer, the pattern of metabolism and excretion appears important, with a higher proportion of methylated arsenic in urine being a marker of higher risk of skin or urinary cancer [ 14 ]. It has been suggested that arsenic acts through an epigenetic mechanism, with exposure leading to DNA methylation regulating gene expression [ 15 ], and as a source of oxidative stress [ 6 ]. Given that arsenic is implicated in cancer causality and that other extrinsic toxins such as tobacco appear to increase the risk of invasive cervical cancer, the opportunity was taken, using methods previously developed to investigate lung, renal and bladder cancer [ 16 , 17 , 18 ], to examine whether residence in an area with high arsenic concentration in well water was associated with a higher risk of cervical cancer.…”

The crosstalk between trace elements with DNA damage response, repair, and oxidative stress in cancer

“…147 As-induced OS in patients with carcinoma of cervix has an association with red blood cell count and hemoglobin level, and the high level of As increases OS in the patients, and increases malondialdehyde (MDA) levels in patients with cervix cancer. 148 Many living cells can convert arsenite to arsenate through oxidation, which generates two electrons for the formation of H 2 O 2 . H 2 O 2 produces OHby Fenton reaction, a very active oxygen radical according to a wide range of macromolecule oxidation.…”