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Proven risk



about this glossary tool

The situations described in this section are those where there is a proven cancer risk: an increased incidence of cancer has clearly been associated with exposure to a known carcinogen.


What is a carcinogen?

A carcinogen is a substance that causes cancer in the body. Many carcinogens are well known and exposure is preventable, such as chemicals in asbestos or tobacco smoke. Some are less well recognised, such as alcohol.


Below is a list of situations where there is a proven cancer risk:


 

People smoking tobacco
Situation People smoking tobacco
Exposure Active smokers
Carcinogen Tobacco smoke, being a mixture containing polycytic aromatic hydrocarbons and the nitrosated derivatives of nicotine and nor-nicotine.
Principal route of exposure Inhalation
Target organ (or tumour type) Lung, oral cavity, naso-oro & hypopharynx, nasal cavity & paranasal sinuses, larynx, stomach, esophagus, pancreas, liver, kidney, ureter, urinary bladder, uterine cervix & bone marrow
Comment Major preventable cause of malignant disease

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People who previously smoked tobacco
Situation People who previously smoked tobacco
Exposure Ex-smokers
Carcinogen Tobacco smoke, being a mixture containing polycytic aromatic hydrocarbons and the nitrosated derivatives of nicotine and nor-nicotine.
Principal route of exposure Previous inhalation
Target organ (or tumour type) Lung, oral cavity, naso-oro & hypopharynx, nasal cavity & paranasal sinuses, larynx, stomach, esophagus, pancreas, liver, kidney, ureter, urinary bladder, uterine cervix & bone marrow
Comment

Risk is reduced by comparison with continued smoking

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Using smokeless tobacco
Situation Using smokeless tobacco
Exposure Users of snuff, chewing tobacco and snus
Carcinogen Tobacco-related nitrosamines
Principal route of exposure Oral
Target organ (or tumour type) Oral cavity, pancreas
Comment Animal data establish role of nitrosamines

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Tanning through sunlamps and solaria
Situation Tanning through sunlamps and solaria
Exposure Persons using the appliances
Carcinogen
Ultraviolet radiation
 
Principal route of exposure Irradiation
Target organ (or tumour type) Skin
Comment Sunlamp data plus carcinogenic hazard established in relation to solar irradiation

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Local atmospheric pollution from point sources of industrial emissions
Situation Local atmospheric pollution from point sources of industrial emissions
Exposure Residents of particular local communities
Carcinogen
Multiple, often unspecified, and including particulate matter, from petrochemical, steel and other industry, mainly involving sites in Europe and the United States.
Principal route of exposure Inhalation
Target organ (or tumour type) Lung, bladder (limited evidence)
Comment Increased risk of lung cancer was consistently observed in cohort and case control studies. Evidence is limited in relation to bladder cancer as most studies have been of employees with potentially high exposure to outdoor air pollution rather than residents.

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General outdoor air pollution
Situation
Whole population
Exposure Worst for residents exposed to high traffic corridors with heavy diesel emissions
Carcinogen
Pollutants include
- Diesel exhaust
- Polycyclic aromatic hydrocarbons
- Benzene
- Formaldehyde
- Particulate matter
Principal route of exposure Inhalation
Target organ (or tumour type) Lung, bladder (limited evidence)
Comment Evidence is limited in relation to bladder cancer as most studies have been of employees with potentially high exposure to outdoor air pollution rather than residents. Air quality monitoring and quantitative assessment is required to adequately characterise risk in differing locations.

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Treatment with certain therapeutic drugs
Situation Treatment with certain therapeutic drugs
Exposure Patients receiving relevant drugs/treatments
Carcinogen
Phenacetin-containing analgesics
Diethylstilboestrol
Cyclophosphamide & other cytotoxic drugs (including combinations)
Combined estrogen-progestogen contraceptives
Principal route of exposure Therapeutic administration
Target organ (or tumour type) Target organ/tumor types specific for particular drug and include leukaemia and cancers of breast, liver, kidney and multiple other sites
Comment Listed agents exemplify, but do not include all therapeutic drugs in the highest IARC/NTP category. Risk-benefit consideration are relevant; some drugs listed are used because of clear benefit despite a recognized hazard

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Drinking alcoholic beverages
Situation Drinking alcoholic beverages
Exposure Consumers of alcoholic beverages, and particularly those who smoke.
Carcinogen Alcoholic beverages; (no class of drink is more markedly implicated than others)
Principal route of exposure Oral
Target organ (or tumour type) Oral cavity, esophagus, liver, breast
Comment No particular category of beverage (beer, wine or spirits) is most strongly implicated.

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Occupational cancer attributable to specific agents
Situation Occupational cancer attributable to specific agents
Exposure Workers handling, or having contact with, particular chemicals or radiation
Carcinogen
Soot and tar
Benzo[a]pyrene
Vinyl chloride
Ionizing radiation Radon
Benzene
Cr VI , Ni, As & Cd compounds
TCDD
Formaldehyde
Principal route of exposure Dermal, inhalation
Target organ (or tumour type) Target organ depends on the agent: most commonly lung, urinary bladder and skin; all sites combined for TCDD
Comment Agents listed are only a subset of known occupational carcinogens. Agents listed are implicated in a non-occupational environmental context addressed in Inferred risks.

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Deliberate exposure to sunlight
Situation Deliberate exposure to sunlight
Exposure White skinned populations
Carcinogen Solar radiation; broad spectrum ultraviolet radiation
Principal route of exposure Irradiation
Target organ (or tumour type) Skin (cutaneous melanoma, squamous cell carcinoma, basal call carcinoma)
Comment Account must also be taken of the beneficial effects of sunlight in relation to vitamin D.

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Particular work environments or job classifications
Situation Particular work environments or job classifications
Exposure Workers eg. work as a painter and work in the rubber industry; environments associated with aluminium production, coke production, furniture & cabinet making; iron & steel founding
Carcinogen Some chemicals implicated (eg exposure to polycyclic aromatic hydrocarbons or aromatic amines) but causality not established because of complex exposures.
Principal route of exposure Inhalation, and in some instances, dermal
Target organ (or tumour type) Lung and other sites
Comment

By comparison with occupational cancers caused by particular agents, specific causative agents have not been identified in relation to the work environments listed.

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Residing near point sources of recognised carcinogens causing extreme local pollution
Situation Residing near point sources of recognised carcinogens causing extreme local pollution
Exposure Relevant local populations
Carcinogen
Asbestos
Coke oven and iron foundry emissions
Arsenic, cadmium and nickels compounds
Principal route of exposure Inhalation in all cases
Target organ (or tumour type) Lung and other sites depending on pollutant
Comment Studies indicate increased cancer risk in local populations, though some studies fail to establish carcinogenic risk in this context.

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Passive smoking
Situation People smoking tobacco
Exposure Children & adults in smoker household; persons exposed as a consequence of smoking in the workplace and other environments
Carcinogen Tobacco smoke passively inhaled
Principal route of exposure Inhalation
Target organ (or tumour type) Lung. Some evidence regarding larynx and other sites
Comment Some inferences in relation to target organs apart from lung (eg. larynx)

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Drinking water contamination from industrial sources of arsenic
Situation Drinking water contamination from industrial sources of arsenic
Exposure Surrounding communities
Carcinogen Arsenic compounds
Principal route of exposure Ingestion
Target organ (or tumour type) Urinary bladder & others
Comment Many relevant studies do not established increased incidence of cancer despite clear evidence of relevant exposure.

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Residential exposure to radon
Situation Residential exposure to radon
Exposure Occupants of particular houses
Carcinogen Radon
Principal route of exposure Inhalation and irradiation (Yes: studies involving home exposure indicate causality)
Target organ (or tumour type) Lung
Comment Carcinogenic hazard established primarily by occupational studies but residential risk is specifically recognised.

This information is based on peer review research published in the journal: B.W. Stewart, Banding carcinogenic risks in developed countries: A procedural basis for qualitative assessment, Mutat. Res.: Rev. Mutat. Res. (2008), doi:10.1016/j.mrrev.2007.11.007.

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This page was last updated on: Friday, March 31, 2017

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