FLUORIDATION AND COUNTY-LEVEL SECONDARY BONE CANCER AMONG CANCER PATIENTS

Water fluoridation continues to be a controversial choice facing communities--dental and skeletal fluorosis in response to chronic fluoride overexposure are cited as reasons to avoid community water fluoridation in spite of evidence of the oral and skeletal health benefits fluoridation confers. Community fluoridation of ~1mg/L fluoride has not been found to be associated with primary bone cancer but is associated with improved bone fortitude. No studies have examined fluoride exposure and secondary bone cancer; we hypothesize that fluoridation may diminish likelihood of secondary bone cancer due to its role in bone fortification. We examined whether there was an association between water fluoridation and prevalence of secondary bone cancer among cancer patients in counties in New York State. Relative to counties with less than 25% of the water supply fluoridated, we report a non-significant decrease in secondary bone cancer among cancer patients in counties with 25%-75% of the water supply fluoridated (β = -0.24, p = 0.59) and among those counties with >75% fluoridated (β = -0.04, p= 0.92). We report no association between fluoridation and secondary bone cancer at the county level.