TY - JOUR
T1 - Urinary cotinine is as good a biomarker as serum cotinine for cigarette smoking exposure and lung cancer risk prediction
AU - Thomas, Claire E.
AU - Wang, Renwei
AU - Adams-Haduch, Jennifer
AU - Murphy, Sharon E.
AU - Ueland, Per Magne
AU - Midttun, Øivind
AU - Brennan, Paul
AU - Johansson, Mattias
AU - Gao, Yu Tang
AU - Yuan, Jian Min
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Cotinine is a metabolite of nicotine. Serum and urinary cotinine are validated biomarkers for cigarette exposure. Their performance for lung cancer risk prediction has not been simultaneously examined in epidemiologic studies. Methods: A nested case–control study, including 452 incident lung cancer cases and 452 smoking-matched controls in the Shanghai cohort study, was conducted. Mass spectrometry–based methods were used to quantify cotinine in serum and urine samples collected from current smokers at baseline, on average 10 years before cancer diagnosis of cases. Logistic regression was used to estimate ORs, 95% confidence intervals (CI), and AUC ROC for lung cancer associated with higher levels of cotinine. Results: Serum and urinary cotinine levels were significantly higher in lung cancer cases than controls. Compared with the lowest quartile serum cotinine (≤0.40 nmol/mL), the OR of lung cancer for smokers in the highest quartiles (>1.39 nmol/mL) was 5.46 (95% CI, 3.38–8.81). Similarly, the OR was 5.49 (95% CI, 3.39–8.87) for highest (>16.38 nmol/mg creatinine) relative to the lowest quartile of urinary total cotinine (≤4.11 nmol/mg creatinine). A risk prediction model yielded an AUC of 0.72 (95% CI, 0.69–0.75) for serum cotinine and 0.72 (95% CI, 0.69–0.75) for urinary total cotinine combined with smoking history. Conclusions: Urinary and serum cotinine have the same performance in prediction of lung cancer risk for current smokers. Impact: Urinary cotinine is a noninvasive biomarker that can replace serum cotinine in risk prediction of future lung cancer risk for current smokers.
AB - Background: Cotinine is a metabolite of nicotine. Serum and urinary cotinine are validated biomarkers for cigarette exposure. Their performance for lung cancer risk prediction has not been simultaneously examined in epidemiologic studies. Methods: A nested case–control study, including 452 incident lung cancer cases and 452 smoking-matched controls in the Shanghai cohort study, was conducted. Mass spectrometry–based methods were used to quantify cotinine in serum and urine samples collected from current smokers at baseline, on average 10 years before cancer diagnosis of cases. Logistic regression was used to estimate ORs, 95% confidence intervals (CI), and AUC ROC for lung cancer associated with higher levels of cotinine. Results: Serum and urinary cotinine levels were significantly higher in lung cancer cases than controls. Compared with the lowest quartile serum cotinine (≤0.40 nmol/mL), the OR of lung cancer for smokers in the highest quartiles (>1.39 nmol/mL) was 5.46 (95% CI, 3.38–8.81). Similarly, the OR was 5.49 (95% CI, 3.39–8.87) for highest (>16.38 nmol/mg creatinine) relative to the lowest quartile of urinary total cotinine (≤4.11 nmol/mg creatinine). A risk prediction model yielded an AUC of 0.72 (95% CI, 0.69–0.75) for serum cotinine and 0.72 (95% CI, 0.69–0.75) for urinary total cotinine combined with smoking history. Conclusions: Urinary and serum cotinine have the same performance in prediction of lung cancer risk for current smokers. Impact: Urinary cotinine is a noninvasive biomarker that can replace serum cotinine in risk prediction of future lung cancer risk for current smokers.
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U2 - 10.1158/1055-9965.EPI-19-0653
DO - 10.1158/1055-9965.EPI-19-0653
M3 - Article
C2 - 31685561
AN - SCOPUS:85077922640
VL - 29
SP - 127
EP - 132
JO - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
SN - 1055-9965
ER -