Abstract: Background: Colorectal cancer is the third most frequent tumor in males and the second in females worldwide. In Spain, it is an important and growing health problem, and epidemiologic research focused on potential risk factors, such as environmental exposures, is necessary. Objectives: To analyze the association between colorectal cancer risk and residential proximity to industries, according to pollution discharge route, industrial groups, categories of carcinogens and other toxic substances, and specific pollutants released, in the context of a population-based multicase-control study of incident cancer carried out in Spain (MCC-Spain). Methods: MCC-Spain included 557 colorectal cancer cases and 2948 controls in 11 provinces, frequency matched by sex, age, and region of residence. Distances were computed from subjects? residences to each of the 134 industries located in the study area. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1 km to 3 km) to industrial facilities, adjusting for matching variables and other confounders. Results: Excess risk (OR; 95%CI) of colorectal cancer was detected near industries overall for all distances analyzed, from 1 km (2.03; 1.44?2.87) to 3 km (1.26; 1.00?1.59). In general, industries releasing pollutants to air showed higher excess risks than facilities releasing pollution to water. By industrial sector, excess risk (OR; 95%CI) was found near (?3 km) production of metals (2.66; 1.77?4.00), surface treatment of metals (1.48; 1.08?2.02), glass and mineral fibers (2.06; 1.39?3.07), organic chemical industry (4.80; 3.20?7.20), inorganic chemical industry (6.74; 4.38?10.36), food/beverage sector (3.34; 2.38?4.68), and surface treatment using organic solvents (6.16; 4.06?9.36). By pollutants, the main excess risks (OR; 95%CI) were found near (?3 km) industries releasing nonylphenol (9.19; 5.91?14.28), antimony (5.30; 3.45?8.15), naphthalene (3.11; 2.16?4.49), organotin compounds (2.64; 1.76?3.98), manganese (2.53; 1.63?3.93), dichloromethane (2.52; 1.74?3.66), and vanadium (2.49; 1.59?3.91). Conclusions: Our results support the hypothesis that residing in the proximity of industries may be a risk factor for colorectal cancer.

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