Circulating cotinine concentrations and lung cancer risk in the Lung Cancer Cohort Consortium (LC3)
Year: 2018
Type: article
Study design: Observational Study
Abstract: Background: Self-reported smoking is the principal measure used to assess lung cancer risk in epidemiological studies. We evaluated if circulating cotinine-a nicotine metabolite and biomarker of recent tobacco exposure-provides additional information on lung cancer risk. Methods: The study was conducted in the Lung Cancer Cohort Consortium (LC3) involving 20 prospective cohort studies. Pre-diagnostic serum cotinine concentrations were measured in one laboratory on 5364 lung cancer cases and 5364 individually matched controls. We used conditional logistic regression to evaluate the association between circulating cotinine and lung cancer, and assessed if cotinine provided additional risk-discriminative information compared with self-reported smoking (smoking status, smoking intensity, smoking duration), using receiver-operating characteristic (ROC) curve analysis. Results: We observed a strong positive association between cotinine and lung cancer risk for current smokers [odds ratio (OR ) per 500 nmol/L increase in cotinine (OR500): 1.39, 95% confidence interval (CI): 1.32-1.47]. Cotinine concentrations consistent with active smoking (≥115 nmol/L) were common in former smokers (cases: 14.6%; controls: 9.2%) and rare in never smokers (cases: 2.7%; controls: 0.8%). Former and never smokers with cotinine concentrations indicative of active smoking (≥115 nmol/L) also showed increased lung cancer risk. For current smokers, the risk-discriminative performance of cotinine combined with self-reported smoking (AUCintegrated: 0.69, 95% CI: 0.68-0.71) yielded a small improvement over self-reported smoking alone (AUCsmoke: 0.66, 95% CI: 0.64-0.68) (P = 1.5x10-9). Conclusions: Circulating cotinine concentrations are consistently associated with lung cancer risk for current smokers and provide additional risk-discriminative information compared with self-report smoking alone.
DOI: 10.1093/ije/dyy100
Authors: Tricia L Larose, Florence Guida, Anouar Fanidi, Arnulf Langhammer, Kristian Kveem, Victoria L Stevens, Eric J Jacobs, Stephanie A Smith-Warner, Edward Giovannucci, Demetrius Albanes, Stephanie J Weinstein, Neal D Freedman, Ross Prentice, Mary Pettinger, Cynthia A Thomson, Qiuyin Cai, Jie Wu, William J Blot, Alan A Arslan, Anne Zeleniuch-Jacquotte, Loic Le Marchand, Lynne R Wilkens, Christopher A Haiman, Xuehong Zhang, Meir J Stampfer, Allison M Hodge, Graham G Giles, Gianluca Severi, Mikael Johansson, Kjell Grankvist, Renwei Wang, Jian-Min Yuan, Yu-Tang Gao, Woon-Puay Koh, Xiao-Ou Shu, Wei Zheng, Yong-Bing Xiang, Honglan Li, Qing Lan, Kala Visvanathan, Judith Hoffman Bolton, Per Magne Ueland, Øivind Midttun, Neil Caporaso, Mark Purdue, Howard D Sesso, Julie E Buring, I-Min Lee, J Michael Gaziano, Jonas Manjer, Hans Brunnström, Paul Brennan, Mattias Johansson
Institutions: Norwegian University of Science and Technology, Centre international de recherche sur le cancer, University of Cambridge, MRC Epidemiology Unit, American Cancer Society, Harvard University, Brigham and Women's Hospital, Division of Cancer Epidemiology and Genetics, Fred Hutch Cancer Center, University of Arizona, Vanderbilt University, Vanderbilt-Ingram Cancer Center, International Epidemiology Institute, New York University, University of Hawaiʻi at Mānoa, University of Hawaii System, University of Hawaii Cancer Center, Cancer Council Victoria, The University of Melbourne, Inserm, Université Paris-Saclay, Centre de recherche en Epidémiologie et Santé des Populations, Italian institute for Genomic Medicine, Umeå University, University of Pittsburgh, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Shanghai Jiao Tong University, Duke-NUS Medical School, Shanghai Cancer Institute, State Key Laboratory of Oncogene and Related Genes, National Cancer Institute, Johns Hopkins University, Haukeland University Hospital, University of Bergen, Bevital (Norway), VA Boston Healthcare System, Lund University, Skåne University Hospital, Region Skåne
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Health and Human Services, World Health Organization, New York City Department of Health and Mental Hygiene, Centre International de Recherche sur le Cancer, Norges Teknisk-Naturvitenskapelige Universitet, Norges Forskningsråd, National Institutes of Health, National Health and Medical Research Council, National Heart, Lung, and Blood Institute, National Cancer Institute, National Institute of Environmental Health Sciences
Awards: G1050918383, Women's Health Study: Continued Follow-Up, Dana Farber/ Harvard Cancer Center SPORE in Gastrointestinal Cancer, G1851278524, G2209176514, G229684361, Prospective studies of cancer etiology and prevention in Shanghai and Singapore, Biochemical Markers in the nurses' Health Study Cohort, G2752888429, G3062349281, G3069585042, G3404704898, One-carbon metabolism biomarkers and lung cancer risk, G3643850837, The NYU Women's Health Study, Dietary and Hormonal Determinants of Cancer in Women, G459566519, The Women's Health Study: Addition of New Data to Maximize its Research Impact, The Women's Health Study: Infrastructure Support for Continued Cohort Follow-up, TRIAL OF ASPIRIN AND VITAMIN E IN WOMEN, G700120080, G7332203415, Cancer epidemiology cohorts in Shanghai and Singapore , Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health Study, Women's Health Study: Continued Follow-up, Cancer Epidemiology Cohort in Male Health Professionals, Women's Health Study: Infrastructure support for cohort follow-up, Novel molecular markers of lung cancer risk and survival, The Singapore Chinese Health Study, G8606882599, G9000019617, G9000043482, G9000058182, G9000312666, Southwest Environmental Health Sciences Center, University of Hawaii Cancer Center CCSG, Understanding Population Differences in Cancer: The MEC Study, G915959914
OpenAlex ID: W2807953401