Understanding the Pathways between Exposure to Heavy Metals and Oncogenesis from a Public Health Perspective, a Rapid Review of Literature.

Cancer is one of the leading causes of death worldwide with progressively increasing incidence related to multiple pathophysiological mechanisms. According to WHO, in 2020 around 18.1 million new cases were reported being breast cancer, the most common with 2.26 million cases followed by lung with 2.20 million and colorectum with 1.93 million. The relationship between cancer and exogenous metal exposure is not new, nevertheless, it was not until recent years that clear pathways were described. Although many metallic elements are required for different physiological and biochemical pathways, at elevated concentrations they have different reported pathological mechanisms. When ingested, heavy metals get oxidized with gastric acid, some become lipophilic, and others induce Reactive Oxygen Species and disrupt processes involving DNA replication, protein synthesis, and folding. The most common heavy metal groups reported include Cadmium (Cd), Lead (Pb), Nickel (Ni), Chromium (Cr), Mercury (Hg), Arsenic (As), and Zinc (Zn), among others. The main objective of this study is to review, the different mechanisms proposed for oncogenesis related to exposure to heavy metal carcinogenesis including, a broad approach to the epidemiology of cancer and its relationship with heavy metals and synthesizing the evidence related to the carcinogenesis of heavy metals and describe the pathophysiological pathway involved in oncogenesis.