THE MOLECULAR EPIDEMIOLOGY OF LUNG-CANCER

One in ten tobacco smokers develops bronchogenic carcinoma over a life time. The study of susceptibility of an individual and a population to lung cancer traditionally has been limited to the study of tobacco sm oke dose and family history of cancer. New insights into lung carcinog enesis have made the study of molecular markers of risk possible in hu man populations in the emerging field of molecular epidemiology. This review summarizes data addressing the relationships of human lung canc er to polymorphisms of phase I procarcinogen-activating and phase II-d eactivating enzymes and intermediate biomarkers of DNA mutation, such as DNA and tumor suppressor gene mutation, and polymorphisms. These pa rameters are reviewed as they relate to tobacco smoke exposure, procar cinogen metabolizing polymorphisms, and the presence oi lung cancer. P roblem areas in biomarker validation, such as cross-sectional data int erpretation, tissue source, race, statistical power, and ethical impli cations are addressed.