Serum Trace Elements and Self-Reported Physician-Diagnosed Tumor History: A Secondary Cross-Sectional Analysis of the Exposure Study on Susceptible People (SPES)

Abstract

Background and Objectives: SPES was a 2016–2017 regional biomonitoring program. We conducted a secondary cross-sectional analysis of associations between current serum trace-element distributions and heterogeneous, self-reported physician-diagnosed tumor history, rather than registry-confirmed or incident cancer. Materials and Methods: Among 4137 questionnaire responders, 86 reported a tumor history. Mixed-effects logistic models for 20 channels were adjusted for age, sex, smoking, and geographic cluster and pooled across 30 completed datasets. Benjamini–Hochberg FDR control was applied across 20 primary comparisons. Results: Higher Cr-52 was associated with lower prevalence odds of reported history (odds ratio per one-standard-deviation increase in log concentration, 0.751; 95% confidence interval, 0.601–0.937; p = 0.011; q = 0.226), but no channel met q < 0.05. Cr-52 was below the limit of quantification in 45/86 (52.3%) participants with reported history and 1646/4048 (40.7%) without. The inverse direction persisted in non-independent complementary analyses; none met the applicable FDR threshold. Conclusions: No channel met the FDR criterion. The Cr-52 pattern was nominal and exploratory. These prevalence associations with a heterogeneous, unvalidated self-reported outcome do not establish temporality, causality, chromium speciation, or a protective effect.