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Predicting who's at risk for lung cancer

Jian-Min Yuan, M.D., Ph.D.

Tobacco researchers with the Masonic Cancer Center, University of Minnesota are on a roll.

In April a team led by Jian-Min Yuan, M.D., Ph.D., announced that it had discovered a direct link between two tobacco byproducts and the development of lung cancer in some smokers. It was the first time a direct link between specific tobacco carcinogens and lung cancer in humans had been identified.

Now the National Cancer Institute has awarded Yuan’s team a five-year, $3 million grant to advance this work.

Yuan’s research has found that high levels of tobacco byproducts called NNAL and cotinine in a person’s urine is predictive of a greater risk of developing lung cancer.

Lung cancer is the leading cause of cancer death in Minnesota, the United States, and the world. Tobacco products are known to contain more than 60 different cancer-causing chemicals, and cigarette smoking is recognized as the chief cause of about 90 percent of lung cancer cases.

“There is no such thing as a safe cigarette,” Yuan says.

Yuan’s research team analyzed urine samples from about 500 smokers over 10 years. The group found that people with high levels of NNAL in their urine had twice the risk of getting lung cancer compared with smokers with low levels of NNAL.

They also found that smokers with high levels of cotinine in their urine had three times the risk of developing lung cancer.

And most significantly, they found that smokers with high levels of both byproducts in their urine were 8.5 times more likely to develop lung cancer in their lifetime than those with low levels.

“Our goal is to develop an effective set of noninvasive, predictive markers that can be used to accurately identify smokers who are at very high risk of developing lung cancer,” Yuan says. “These people can then be closely followed for early detection and helped to change their lifestyle.”

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