Higher levels of cadmium, arsenic, and lead in the body appear to be associated with an increased risk of pancreatic cancer, according to results from a Spanish study.  Nuria Malats, from the Spanish National Cancer Center (Spain), and colleagues analyzed toenail clippings obtained from 118 patients with exocrine pancreatic cancer who were enrolled in the PANKRAS 2 Study, conducted in 1992-1995. For their control group, the team obtained toenail clippings from 399 participants in the Spanish Bladder Cancer/EPICURO Study of 1998-2001.  The toenail clippings, which had been stored at room temperature until analysis, had their trace elements quantified using inductively coupled plasma mass spectrometry. Samples also underwent acid digestion and gravimetric recording for assay purposes. A separate analysis was performed to assess median concentrations of trace elements between cases and controls. After confounding variables were excluded, the researchers found that exocrine pancreatic cancer risk was significantly increased among subjects whose concentrations of cadmium, arsenic, and lead were in the highest quartile. The researchers also found that levels of nickel and selenium were inversely associated with exocrine pancreatic cancer risk.  The study authors conclude that: “Novel associations are reported of lead, nickel and selenium toenail concentrations with pancreas cancer risk. Furthermore, the results confirm previous associations with cadmium and arsenic.”