Lifetime Swimming Pool Attendance and Cancer Risk: Findings from the Multicase-Control Study in Spain (MCC-Spain)

Swimming in pools involves inhalation and skin absorption of potential carcinogenic disinfection byproducts (DBPs) as well as physical activity, which is protective for some cancer sites. We evaluated the association between lifetime pool attendance and the risk of breast, colorectal, and prostate cancer in a multicase-control study that recruited 4,941 hospital-based cancer cases (1,724 breast, 2,111 colorectal, 1,106 prostate) and 4,039 population-based controls in Spain (2008-2013). Lifetime swimming pool attendance in summer (as a surrogate of outdoor pools) and the rest of the year (as a surrogate of indoor pools), socio-demographics, and lifestyle were ascertained in face-to-face interviews. Cancer risk associated with pool attendance markers was estimated using linear mixed-effect models, adjusting for covariates with recruitment area as a random effect. Participants reporting lifetime pool attendance compared to those who did not showed lower odds of breast and colorectal cancer (approximately 5% lower risk). Swimming more than 10 times/month did not increase the protective association. For breast and colorectal cancer, only pool attendance outside the summer months was associated with a lower risk, whereas it was associated with increased prostate cancer risk. Findings suggest that lifetime swimming in pools may reduce breast cancer and colorectal cancer risk despite DBP exposure. These novel findings require replication.

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Publication Details

Journal
Environmental Science & Technology
Published
2025-11-03
DOI
https://doi.org/10.1021/acs.est.5c06488
Primary Topic
Water Treatment and Disinfection
Type
article
Field-Weighted Citation Impact
0.00

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article

Lifetime Swimming Pool Attendance and Cancer Risk: Findings from the Multicase-Control Study in Spain (MCC-Spain)

Ana Molina‐Barceló, Guillermo Fernández‐Tardón, Cristina M. Villanueva, Marina Pollán et al.
Environmental Science & Technology
Water Treatment and Disinfection
article

Lifetime Swimming Pool Attendance and Cancer Risk: Findings from the Multicase-Control Study in Spain (MCC-Spain)

Ana Molina‐Barceló, Guillermo Fernández‐Tardón, Cristina M. Villanueva, Marina Pollán, María‐Dolores Chirlaque, Manolis Kogevinas, Inés Gómez‐Acebo, Ana Jiménez-Zabala, Carolina Donat‐Vargas, Vı́ctor Moreno, Marcela Guevara, Núria Aragonés, Elena Boldo, Antonio J. Molina, Pilar Amiano, Miquel Vallbona‐Vistós, Gemma Castaño-Vinyals
article en

Abstract

Swimming in pools involves inhalation and skin absorption of potential carcinogenic disinfection byproducts (DBPs) as well as physical activity, which is protective for some cancer sites. We evaluated the association between lifetime pool attendance and the risk of breast, colorectal, and prostate cancer in a multicase-control study that recruited 4,941 hospital-based cancer cases (1,724 breast, 2,111 colorectal, 1,106 prostate) and 4,039 population-based controls in Spain (2008-2013). Lifetime swimming pool attendance in summer (as a surrogate of outdoor pools) and the rest of the year (as a surrogate of indoor pools), socio-demographics, and lifestyle were ascertained in face-to-face interviews. Cancer risk associated with pool attendance markers was estimated using linear mixed-effect models, adjusting for covariates with recruitment area as a random effect. Participants reporting lifetime pool attendance compared to those who did not showed lower odds of breast and colorectal cancer (approximately 5% lower risk). Swimming more than 10 times/month did not increase the protective association. For breast and colorectal cancer, only pool attendance outside the summer months was associated with a lower risk, whereas it was associated with increased prostate cancer risk. Findings suggest that lifetime swimming in pools may reduce breast cancer and colorectal cancer risk despite DBP exposure. These novel findings require replication.

Environmental Science & TechnologyVol. 59(45)
Madrid Institute for Advanced Studies (ES), Universidad de Cantabria (ES), Universitat Pompeu Fabra (ES), Instituto de Salud Carlos III (ES), Karolinska Institutet (SE), Instituto de Salud Pública de Navarra (ES), Institut d'Investigació Biomédica de Bellvitge (ES), General Department of Preventive Medicine (VN), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (ES), Ajuntament de L’Hospitalet (ES), Navarre Institute of Health Research (ES), Instituto de Investigación Marqués de Valdecilla (ES), Collaborative Group (United States) (US), Policlínica Gipuzkoa (ES), Madrid Health Service (ES), Hospital Del Mar (ES), Hospital Universitario Central de Asturias (ES), Municipal Institute for Medical Research (ES), Instituto Murciano de Investigación Biosanitaria (ES), Barcelona Institute for Global Health (ES), Diputación Foral de Gipuzkoa (ES), Universitat de Barcelona (ES), Universidad de Murcia (ES), Universidad de León (ES)
Universitat Pompeu Fabra, Karolinska Institutet, Universidad de Murcia, Universitat de Barcelona, Universidad de Cantabria, Instituto de Investigación Marqués de Valdecilla, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Instituto de Salud Carlos III
Openalex Percentile: Top 58%
Water Treatment and Disinfection
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