Prediagnostic toenail cadmium and zinc and subsequent prostate cancer risk

Elizabeth A. Platz, Kathy J. Helzlsouer, Sandra C. Hoffman, J. Steven Morris, Connie K. Baskett, George W. Comstock

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


BACKGROUND. Cadmium is a recognized human lung carcinogen that has also been positively associated with prostate cancer mainly in occupationally exposed men. The association between dietary and supplemental zinc intake and prostate cancer has not been consistent in epidemiologic studies. We evaluated the association between prediagnostic toenail cadmium and zinc concentrations and risk of prostate cancer in a cohort in which the primary route of exposure to cadmium and zinc is the diet. METHODS. Included in the analysis were 115 prostate cancer cases and 227 age-matched controls nested in the prospective CLUE II study located in Washington County, MD. Participants provided toenail samples at baseline in 1989. Furnace atomic absorption and flame atomic absorption were used to determine toenail cadmium and zinc concentrations, respectively. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from conditional logistic regression models. RESULTS. Median toenail cadmium and zinc concentrations did not statistically significantly differ between prostate cancer cases (cadmium, 45.9 ppb; zinc, 155.3 ppm) and controls (cadmium, 54.5 ppb; zinc, 164.0 ppm). Prostate cancer risk did not increase with increasing concentrations of cadmium (P trend = 0.9) and did not decrease with increasing concentrations of zinc (P trend = 0.2). For both metals, the ORs for the top four fifths were each below 1.0 when compared with the bottom fifth. CONCLUSION. Men who have high toenail cadmium concentrations in the range observed in this general population sample were not at an increased risk for prostate cancer. Although there was no evidence of a linear dose-response, these findings suggest that risk of prostate cancer may be slightly lower among men with moderate and higher zinc intake.

Original languageEnglish (US)
Pages (from-to)288-296
Number of pages9
Issue number4
StatePublished - Sep 1 2002


  • Cadmium
  • Nested case-control study
  • Prostate cancer
  • Zinc

ASJC Scopus subject areas

  • Oncology
  • Urology


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