Abstract
A nested lung cancer case-control study was carried out using 397 12 h urine samples originally collected from a cohort of over 26,000 women aged 40-64 at entry who were then followed for up to 15 years. The urine samples from active smokers were first identified using a simple qualitative method and their total nicotine metabolites/creatinine ratios then determined by automated colorimetric methods. The results obtained demonstrated the capacity of nicotine metabolite estimations in a single 12 h sample of urine to predict the subsequent risk of lung cancer. The risk of lung cancer among the biochemically proven active smokers during this period was 7.8 times that of the non-smokers, suggesting that the dose-response relationship between smoking and lung cancer is no less step in women than in men. The smoking-related risk of adenocarcinoma was less than that of other lung carcinomas. It is suggested that this biochemical epidemiology approach to exploring the relationship between smoking and lung cancer could profitably be applied to the study of other smoking-related diseases.
Highlights
The limitations to studying the dose dependence of lung cancer among active or passive smokers using self-reported daily cigarette consumptions or exposures to environmental tobacco smoke have been discussed in our companion paper (De Waard et al, 1995)
This paper described the successful application of a direct biochemical epidemiological approach in which the risks of developing lung cancer among both active and passive smokers were shown to be highly correlated with the ratios of cotinine,/creatinine in single 12 h urine samples collected up to 15 years previously
Studies employing gas chromatography-mass spectrometry (GC- MS) techniques for estimating all the major metabolites of nicotine have shown that the proportions of inhaled nicotine doses eliminated in the urine as cotinine by active smokers vary greatly between individuals (Byrd et al, 1992; Benowitz et al, 1994)
Summary
In 1974 a population-based screening programme was initiated for the early detection of breast cancer in a cohort of over 26 000 women aged 40-64 living in the city of Utrecht (the DOM project). It was possible to make use of The Netherlands Cancer Registry Linkage with this register was performed in such a way that legal requirements for privacy protection were met. This gave the opportunity to perform a nested case-control study. A detailed description of the identification of the lung cancer cases, logistics of the collection and retrieval of the urine samples, and the GC-MS determination of their cotimine concentrations is given in the accompanying paper A detailed description of the identification of the lung cancer cases, logistics of the collection and retrieval of the urine samples, and the GC-MS determination of their cotimine concentrations is given in the accompanying paper (De Waard et al.. 1995)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
