The level of DNA adducts under the same conditions of carcinogen exposure and cell proliferation reflects an integrated measure of carcinogen metabolism and DNA repair. Therefore, such DNA adduct levels have the potential to be a biomarker for susceptibility to chemical carcinogenesis. In a pilot study of 91 patients with squamous cell carcinomas of the head and neck and 115 controls who were frequency matched by age, sex, ethnicity, and smoking status, we applied a newly developed in vitro assay of benzo[a]pyrene diol epoxide (BPDE)-induced DNA adducts in short-term peripheral lymphocytes cultures. Levels of BPDE-DNA adducts were found to be significantly higher in cases than in controls (mean ؎ SD, 76.8 ؎ 77.4/10 7 and 47.1 ؎ 48.0/10 7 nucleotides, respectively; p < 0.001). Using the median level of control values (35/10 7 ) as the cut-off point, about 66% of cases were distributed above this level. Logistic regression analysis revealed that the level of BPDE-induced DNA adducts was an independent risk factor (odds ratio ؍ 2.22; 95% confidence interval ؍ 1.22-4.04) after adjustment for age, sex and smoking status. Further stratified analyses showed that levels of the induced adducts between cases and controls were significantly higher in both age groups, that is, younger or older than 60, as well as in both men and women. Smoking had a positive effect on the induced adducts. The highest level of induced adducts was seen in current smokers, then former smokers and non-smokers. There was a statistically significant dose-response relationship between the quartile levels of BPDE-induced DNA adducts and the risk of head and neck cancer (trend test, p ؍ 0.003). Despite the relatively small sample size, the association of BPDE-induced DNA adducts and cancer risk suggests that this assay has the potential to complement with other biomarkers in identifying individuals at increased risk of developing tobacco-related cancers. © 2001 Wiley-Liss, Inc.
Key words: DNA repair; genetic susceptibility; molecular epidemiologyCigarette smoking causes about 30% of all cancer deaths in the United States. 1 However, the fact that only a fraction of smokers develop cancer indicates that genetic susceptibility plays a role in tobacco carcinogenesis. Biomarkers for such susceptibility are needed for identifying individuals at high risk who might benefit from intensive cancer prevention strategies.Recently, numerous biomarkers for genetic susceptibility have been applied to molecular epidemiological studies of smokingrelated human cancers. 2-6 Among these markers, polymorphisms of genes in carcinogen activation, detoxification and DNA repair have been used most extensively. However, as more genes with genetic polymorphisms are being identified, it is difficult to measure all related polymorphisms in one study and it is not sufficient to measure an individual's susceptibility by genotyping alone. Some phenotypic biomarkers, on the other hand, can detect functional differences determined by many genes. DNA adduct is one of these phe...