Abstract
This study aims to identify common contaminants in well water linked to an increase in colorectal cancer (CRC) incidence rates in North Dakota (ND) counties. County-specific incidence rates for CRC were obtained from the ND Statewide Cancer Registry. Corresponding demographic, agricultural, and geophysical data were obtained from population-based sources. Associations between well water contaminants and CRC incidence were examined for 16 counties in ND with complete well water profiles between 1997-2019. Data were analyzed by multiple linear regression. Iron in well water exhibited a significant positive association with CRC incidence (4.75, P = 0.001), and barium exhibited a small, but significant negative association (-0.06907, P = 0.01). Residents in counties in ND with prevalent well water usage contaminated with iron may be at higher risk for CRC.