德克萨斯州的肝细胞癌 (HCC) 发病率是美国最高的。接触有毒物质可能会导致肝脏疾病。砷致癌的几种机制已经被提出，然而，人类的证据仅限于肝癌与摄入砷污染的饮用水之间的关联。通过一项生态研究，我们研究了环境砷与 HCC 发病率之间的关联。主要结果是基于德克萨斯州癌症登记 (TCR) 数据的 HCC 发病率。主要关注的暴露是美国环境保护署 2011 年国家空气毒性评估 (NATA) 中砷暴露浓度 (EC) 的模拟人口普查区水平估计值。我们使用负二项泊松回归模型分别对基于种族/民族和性别的六个研究组分析了砷 EC 与 HCC 之间的关联。我们调整了选定特征的主要分析。德克萨斯州有 5265 个人口普查区，TCR 报告 2007 年至 2015 年间有 18,235 例新的 ≥20 岁 HCC 诊断。我们观察到种族、民族和性别群体之间存在显着差异，同时考虑到社会经济剥夺、城市/农村居住权和老年居民的健康保险状况。砷 EC 最高的人口普查区的新罕布什尔州黑人男性（五分位数 5 与五分位数 1：IRR=2.18，95% CI：1.67-2.86）和新罕布什尔州黑人女性（五分位数 5 与五分位数 1：IRR= 1.72，95% CI：1.33-2.22）和新罕布什尔州白人（五分位数 5 与五分位数 1：IRR=1.38，95% CI：1.24-1.54）。其余研究组中的关联要么不一致，要么减弱。我们的发现表明砷与 HCC 关联存在潜在的吸入途径；然而，我们研究的生态性质无法解释空气中砷暴露与肝癌之间的因果关系。这一发现需要在队列研究中进一步检验。版权所有 © 2023。由 Elsevier Inc. 出版。

Texas has the highest rates of hepatocellular carcinoma (HCC) in the United States. Exposure to toxicants may play a role in liver disease. Several mechanisms of arsenic carcinogenesis have been proposed, however, the evidence in human populations is limited to associations between HCC and ingestion of arsenic-contaminated drinking water. Through an ecological study, we examined associations between ambient arsenic and HCC incidence rates.Primary outcome was HCC incidence rates based on Texas Cancer Registry (TCR) data. Primary exposure of interest was the simulated census-tract level estimate of arsenic exposure concentration (EC) from the US Environmental Protection Agency 2011 National Air Toxics Assessment (NATA). We analyzed the association between the arsenic EC and HCC using the negative binomial Poisson regression model separately for six study groups that were based on race/ethnicity and sex. We adjusted the main analyses for selected characteristics.Texas has 5265 census tracts and TCR reported 18,235 new ≥20 years old HCC diagnoses between 2007 and 2015. We observed significant differences along racial-ethnic and sex groups while accounting for socioeconomic deprivation, urban/rural residency, and senior residents' health insurance status. Census tracts with the highest arsenic EC had elevated rates of HCC among NH black men (Quintile 5 vs. Quintile 1: IRR = 2.18, 95% CI: 1.67-2.86), NH black women (Quintile 5 vs. Quintile 1: IRR = 1.72, 95% CI: 1.33-2.22) and NH white men (Quintile 5 vs. Quintile 1: IRR = 1.38, 95% CI: 1.24-1.54). The associations in the remaining study groups were either inconsistent or attenuated.Our finding suggests a potential inhalation pathway for the Arsenic-HCC association; however, the ecological nature of our study precludes the interpretation of a causal link between exposure to aerial arsenic and HCC. This finding needs to be further examined in cohort studies.Copyright © 2023. Published by Elsevier Inc.