Associations between Biomarkers of Exposure and Lung Cancer Risk among Exclusive Cigarette Smokers in the Golestan Cohort Study.

Abstract

Biomarkers of tobacco exposure are known to be associated with disease risk but previous studies are limited in number and restricted to certain regions. We conducted a nested case-control study examining baseline levels and subsequent lung cancer incidence among current male exclusive cigarette smokers in the Golestan Cohort Study in Iran. We calculated geometric mean biomarker concentrations for 28 matched cases and 52 controls for the correlation of biomarker levels among controls and for adjusted odds' ratios (ORs) for lung cancer incidence by biomarker concentration, accounting for demographic characteristics, smoking quantity and duration, and opium use. Lung cancer cases had higher average levels of most biomarkers including total nicotine equivalents (TNE-2), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and 3-hydroxyfluorene (3-FLU). Many biomarkers correlated highly with one another including TNE-2 with NNAL and N-Acetyl-S-(2-cyanoethyl)-L-cysteine (2CYEMA), and N-Acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine (t4HBEMA) with N-Acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine (3HMPMA) and N-Acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-L-cysteine (4HMBEMA). Lung cancer risk increased with concentration for several biomarkers, including TNE-2 (OR = 2.22, 95% CI = 1.03, 4.78) and NNN (OR = 2.44, 95% CI = 1.13, 5.27), and estimates were significant after further adjustment for demographic and smoking characteristics for 2CYEMA (OR = 2.17, 95% CI = 1.03, 4.55), N-Acetyl-S-(2-carbamoylethyl)-L-cysteine (2CAEMA) (OR = 2.14, 95% CI = 1.01, 4.55), and N-Acetyl-S-(2-hydroxypropyl)-L-cysteine (2HPMA) (OR = 2.85, 95% CI = 1.04, 7.81). Estimates were not significant with adjustment for opium use. Concentrations of many biomarkers were higher at the baseline for participants who subsequently developed lung cancer than among the matched controls. Odds of lung cancer were higher for several biomarkers including with adjustment for smoking exposure for some but not with adjustment for opium use.

• Authors: Brian L Rostron, Jia Wang, Arash Etemadi, Sapna Thakur, Joanne T Chang, Deepak Bhandari, Julianne Cook Botelho, Víctor R De Jesús, Jun Feng, Mitchell H Gail, Maki Inoue-Choi, Reza Malekzadeh, Akram Pourshams, Hossein Poustchi, Gholamreza Roshandel, Meredith S Shiels, Qian Wang, Yuesong Wang, Baoyun Xia, Paolo Boffetta, Paul Brennan, Christian C Abnet, Antonia M Calafat, Lanqing Wang, Benjamin C Blount, Neal D Freedman, Cindy M Chang
• Journal: International journal of environmental research and public health (Int J Environ Res Public Health) Vol. 18 Issue 14 (07 09 2021) ISSN: 1660-4601 [Electronic] Switzerland
• PMID: 34299799 (Publication Type: Journal Article, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Biomarkers
• Carcinogens
• Nitrosamines

Topics

• Biomarkers
• Carcinogens
• Case-Control Studies
• Cohort Studies
• Humans
• Lung Neoplasms (epidemiology)
• Male
• Nitrosamines
• Smokers
• Tobacco Products