Cancer
Tobacco-related urinary biomarkers and lung cancer risk in women, a case-cohort analysis Mahdi Nalini* Mahdi Nalini Arash Etemadi Christian C Abnet Katie O’Brien Dale Sandler Cindy Chang Benjamin C. Blount Lanqing Wang Antonia M Calafat Deepak Bhandari Neal D. Freedman
Background: Carcinogenic components of tobacco smoke, particularly those contributing to the lung cancer risk among women, have yet to be clearly identified. We assessed associations between biomarkers of polycyclic aromatic hydrocarbons (PAHs), tobacco-specific nitrosamines (TSNAs), and volatile organic compounds (VOCs) and lung cancer incidence among women across the United States.
Methods: In a case-cohort analysis within the Sister Study cohort (50,884 women, 35-74 years, enrolled 2003-2009), data were obtained for all incident lung cancers through September 15, 2017, and a random subcohort stratified by ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, others) and smoking status (current, past, never). We measured 30 biomarkers in baseline urine samples and calculated hazard ratios (HRs) for the associations between a one-unit increase in the natural logarithm of biomarker concentrations and lung cancer incidence using weighted Cox regression models adjusted for potential confounders.
Results: Our sample included 356 cases and 433 non-case participants during a follow-up of 9.6 years. Among current smokers, associations were observed for biomarkers of PAHs (naphthalene, phenanthrene, pyrene, fluorene; HRs:1.4-5.3), TSNAs (N’-nitrosoanabasine, N’-nitrosoanatabine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNAL);HRs:1.3-2.5), and VOCs (xylene, acrylamide, acrylonitrile, 1,2-dibromoethane/vinyl-chloride/ethylene-oxide/acrylonitrile, acrolein, styrene/ethylbenzene, benzene, dimethylformamide/methylisocyanate, 1,3-butadiene, crotonaldehyde, isoprene;HRs:1.6-4.4). The associations for most PAH biomarkers were independent of nicotine metabolites, NNAL, and smoking frequency and duration. In women who did not smoke at baseline, associations were observed for styrene/ethylbenzene and dimethylformamide/methylisocyanate biomarkers.
Conclusion: We found direct evidence of associations between several PAH, TSNA, and VOC biomarkers and lung cancer risk in women.