Research: Rebuke Claims of Disorders: Osteosarcoma
“Fluoride exposure does not increase the risk of osteosarcoma and may be protective in males. The protective effect may not be directly due to fluoride exposure but may be due to other factors associated with good dental hygiene. There is also a biologic plausability for a protective effect.”
KittyH. Gelberg, PhD, MPH, Edward F. Fitzgerald, PhD, Syni-an Hwang, PhD, andRobertDubrow,MD, PhD(Am J Public Health 1995;85:1678-1683)Osteosarcoma1995 Gelberg Fluoride Exposure and childhood Osteosarcoma – A Case-Control StudyRead Full Study
“We conclude that there is no substantiated evidence from studies of human populations that fluoride or fluoridation causes cancer, or increases mortality from cancer, whether for cancer as a whole or for cancer at individual sites. The notion that fluoridation and cancer were associated seems to have arisen as a result ofthe fact that, amongst the major cities ofthe United States, fluoridation was introduced earliest in those which were relatively disadvantaged in social and economic terms (as can be seen by the effects of the corrections for such factors in the paper of Erickson, 1978), which already had relatively high standardised cancer rates (Oldham and Newell, 1977) and which, because the proportion of the elderly was increasing particularly fast, had crude rates which were increasing particularly fast. Each of the epidemiological studies whose authors have concluded or implied that fluoridation causes cancer has been shown to be unsoundly based. The conclusions of those studies arose from elementary errors, most importantly a failure to use standard and well tried approaches which would allow properly for these important demographic and socioeconomic differences between populations. In addition these authors employed many inappropriate unvalidated methods; many of the types of error which we have described in Chapter 1 played a part in the false conclusions reached by Yiamouyiannis, Burk, Brady, Schatz and Schatz, and Cecilioni. Each of these authors has failed to ask the fundamental question proposed by Bradford Hill (1977): ”Is there any other answer which is more likely than cause and effect?”. Their repeated analyses, principally ofjust two basic sets of data, but with a variety of method and argument, may have given the impression of a complex body of evidence; on examination, however, each strand ofthat evidence is unsound and the conclusions drawn from it by the authors can be unreservedly dismissed. It has been left to other authors’ studies ofcancer rates in the same populations, and often ofthe same data, to show that there is in fact no evidence of an adverse effect when well-established and sound methods of analysis are used.”
Fluoridation of Water and Cancer: A Review of the Epidemiological Evidence Report of the Working Party Chairman: Professor E G Knox
London Her Majesty’s Stationery Office
The authors reviewed scientific evidence to inform Ireland Department of Health with regard to any impact, positive and or negative, on the general health of those exposed to community water fluoridation at the levels of 0.4-1.5 ppm. Based on the existing literature available before 2015, this report concluded that the effects of fluoride in drinking water on osteosarcoma incidence are mixed and no link has been proven. The authors recommended a good quality longitudinal research to affirm or rule out these suggested links.
Health effects of water fluoridation: An evidence review 2015
Sutton M, Kiersey R, Farragher L, Long J.
Proxy exposure measures and readily available data from the Wisconsin Cancer Reporting System were used to contrast 167 osteosarcoma cases with 989 frequency-matched cancer referents reported during 1979-1989. Differences in potential exposure to water-borne radiation and fluoridated drinking water, population size for the listed place of residence, and seasonality were assessed. An association was found between osteosarcoma and residence in a population of less than 9,000 (odds ratio = 1.6, 95% confidence interval = 1.1-2.4). In addition, an association between month of birth (May through July versus other months of birth) and osteosarcoma among individuals who were less than 25 y of age (odds ratio = 1.9, 95% confidence interval = 1.1-3.4). Overall, no association was found between potential exposure to fluoridated drinking water and osteosarcoma (odds ratio = 1.0, 95% confidence interval = 0.6-1.5). The association between osteosarcoma and water-borne radiation was weak and was not significant statistically (odds ratio = 1.5, 95% confidence interval = 0.8-2.8).
Osteosarcoma, seasonality, and environmental factors in Wisconsin, 1979-1989.
Moss ME1, Kanarek MS, Anderson HA, Hanrahan LP, Remington PL.
Arch Environ Health. 1995 May-Jun;50(3):235-41.
In response to concerns over the possible carcinogenicity of fluoride compounds added to drinking water raised by the results of a recent animal experiment, we evaluated 36 years of US.cancer mortality data and 15 years of cancer incidence data from two population-based cancer registries, in relation to the fluoridation status of drinking water supplies in the populations under study. Osteosarcomas of the bone were singled out for detailed analysis based on the results of the animal experiment. Among both males and females residing in counties having undergone rapid fluoridation, the relative risk of death from cancers of the bones and joints was the same after 20-35 years of fluoridation as it was in the years immediately preceding fluoridation. A similar lack of a relationship to timing of fluoridation was noted for the incidence of bone and joint cancers, and osteosarcomas. The relative risk of developing these cancers 20 or more years after fluoridation was lower than the risk associated with less than five years of fluoridation among both males and females. The mortality and incidence data in this survey allowed an evaluation of the patterns of risk for virtually all forms of cancer in relation to the timing of fluoridation of drinking water supplies. For no type of malignancy was there consistent evidence of a relationship with the patterns of fluoridation. One site, renal cancer, showed a suggestive relationship between incidence rates and duration of fluoridation in the aggregate data from the registries. However, no such trends were seen when incidence data were examined for two separate periods, and the mortality data for renal cancer actually yielded some evidence of an inverse relationship with duration of fluoridation.
Thus, in a study of over 2,300,000 cancer deaths in fluoridated counties across the United States, and over 125,000 incident cancer cases in fluoridated counties covered by two population-based cancer registries, we identified no trends in cancer risk that could be ascribed to the consumption of fluoridated drinking water.
FLUORIDATION OF DRINKING WATER AND SUBSEQUENT CANCER INCIDENCE AND MORTALITY Robert N. Hoover, M.D., Sc.D., Susan S, Devesa, Ph.D., Kenneth P. Cantor, Ph.D., Jay H. Lubin, Ph.D., and Joseph F. Fraumeni, Jr., M.D. From: Epidemiology and Biostatistics Program, Division of Cancer Etiology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
“Conclusion: In a case-control study of osteosarcoma patients and hospital-based matched controls, the ingestion of fluoridated water was not found to be a risk factor for osteosarcoma. Hence, no link was found between the occurrence of osteosarcoma and ingestion of residential fluoridated water over the course of a lifetime or during the years of bone development. Given present knowledge, every effort should be made to continue the practice of fluoridating community water supplies.”
Is There A Link Between Fluoridated Water and Osteosarcoma?
Sheila M. McGuire D.D.S., M.S., Eleanor D. Vanable, ED.D., Michael H. McGuire, M.D., Joseph A. Buckwalter, M.D., Chester W. Douglass, D.M.D., PhD .
JADA, Vol. 122, April 1991
Three hundred and eight osteosarcoma cases, 598 leukemia controls, and 604 CNS tumor controls met selection criteria and were assigned a corresponding PWS fluoride level. PWS fluoride level was not associated with osteosarcoma, either in a univariable analysis or after adjusting for age, sex, race, and poverty index. Stratified analyses by sex were conducted; no association between PWS fluoride level and osteosarcoma was observed among either males or females.
No relationship was found between fluoride levels in public drinking water and childhood/adolescent osteosarcoma in Texas.
Fluoride exposure in public drinking water and childhood and adolescent osteosarcoma in Texas
Natalie P. Archer , Thomas S. Napier, John F. Villanacci
Cancer Causes & Control. pp 1-6
First online: 17 May 2016
The association between fluoride and risk for osteosarcoma is controversial. The purpose of this study was to determine if bone fluoride levels are higher in individuals with osteosarcoma. Incident cases of osteosarcoma (N = 137) and tumor controls (N = 51) were identified by orthopedic physicians, and segments of tumor-adjacent bone and iliac crest bone were analyzed for fluoride content. Logistic regression adjusted for age and sex and potential confounders of osteosarcoma was used to estimate odds ratios (OR) and 95% confidence intervals (CI). There was no significant difference in bone fluoride levels between cases and controls. The OR adjusted for age, gender, and a history of broken bones was 1.33 (95% CI: 0.56-3.15).
J Dent Res. 2011 Oct;90(10):1171-6. doi: 10.1177/0022034511418828. Epub 2011 Jul 28.An assessment of bone fluoride and osteosarcoma.
Kim FM, Hayes C, Williams PL, Whitford GM, Joshipura KJ, Hoover RN, Douglass CW; National Osteosarcoma Etiology Group.
The incidence of osteosarcoma in Northern Ireland was compared with that in the Republic of Ireland to establish if differences in incidence between the two regions could be related to their different drinking water fluoridation policies. Data from the Northern Ireland Cancer Registry (NICR) and the National Cancer Registry of Ireland (NCRI) on osteosarcoma incidence in the respective populations were used to estimate the age-standardised and age-specific incidence rates in areas with and without drinking water fluoridation. One hundred and eighty-three osteosarcoma cases were recorded on the island of Ireland between 1994 and 2006. No significant differences were observed between fluoridated and non-fluoridated areas in either age-specific or age-standardised incidence rates of osteosarcoma. The results of this study do not support the hypothesis that osteosarcoma incidence in the island of Ireland is significantly related to public water fluoridation. However, this conclusion must be qualified, in view of the relative rarity of the cancer and the correspondingly wide confidence intervals of the relative risk estimates.
—-Osteosarcoma Incidence on the Island of Ireland
Harry Comber, Sandra Deady, Erin Montgomery, Anna Gavin
Cancer Causes & Control
June 2011, Volume 22, Issue 6, pp 919-924
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We found no sex-specific statistical differences in the national incidence rates in the younger groups (5–9, 10–14), although 15–19 males were at higher risk to osteosarcoma than females in the same age group (p < 0.001). Sex and age group specific incidence rates were similar in both CWF state categories. The higher incidence rates among 15–19 year old males vs females was not associated with the state fluoridation status. We also compared sex and age specific osteosarcoma incidence rates cumulated from 1973 to 2007 from the SEER 9 Cancer Registries for single age groups from 5 to 19. There were no statistical differences between sexes for 5–14 year old children although incidence rates for single age groups for 15–19 year old males were significantly higher than for females.
Our ecological analysis suggests that the water fluoridation status in the continental U.S. has no influence on osteosarcoma incidence rates during childhood and adolescence.
April 2012, Vol.36(2):e83–e88, doi:10.1016/j.canep.2011.11.008
Michael Levy, Bernard-Simon Leclerc
The study analysed 2566 osteosarcoma and 1650 Ewing sarcoma cases. There was no evidence of an association between osteosarcoma risk and fluoride in drinking water [relative risk (RR) per one part per million increase in the level of fluoride = 1·001; 90% confidence interval (CI) 0·871, 1·151] and similarly there was no association for Ewing sarcoma (RR = 0·929; 90% CI 0·773, 1·115).
The findings from this study provide no evidence that higher levels of fluoride (whether natural or artificial) in drinking water in GB lead to greater risk of either osteosarcoma or Ewing sarcoma.
Int J Epidemiol. 2014 Jan 14. [Epub ahead of print]
Is fluoride a risk factor for bone cancer? Small area analysis of osteosarcoma and Ewing sarcoma diagnosed among 0-49-year-olds in Great Britain, 1980-2005.
Blakey K, Feltbower RG, Parslow RC, James PW, Gómez Pozo B, Stiller C, Vincent TJ, Norman P, McKinney PA, Murphy MF, Craft AW, McNally RJ.