Problems in assessing the relative predictive value of internal markers versus external exposure in chronic disease epidemiology.
Steenland K; Tucker J; Salvan A
Cancer Epidemiol Biomark Prev 1993 Sep; 2(5):487-491
The relative epidemiological value of using internal exposure markers (biomarkers) and external exposure markers as predictors of chronic disease was investigated. Several models reflecting the different possible relationships of exposure, biomarker, and disease were analyzed. Biomarkers were shown to be superior to exposure as a predictor of disease in cases where the biomarker represented a true intermediate variable, and where it represented an ancillary variable associated with a variable on the disease pathway. Biomarker prediction was also tested by determining whether disease development was more likely or more frequent in cases where exposure levels were equal but biomarker levels were higher. The effectiveness and limitation of biomarkers as predictors of disease were assessed in cases involving the association between carcinogen exposure, cytogenetic effects and cancer or asbestos (1332214) exposure, asbestosis and lung cancer. The authors conclude that the difficulty in determining the specific contributions of exposure and biomarkers on disease outcome may limit their practical use as a predictive tool for chronic disease in cases where long term data on exposure and the marker are not available.
NIOSH-Author; Biological-effects; Biological-monitoring; Analytical-models; Carcinogens; Lung-cancer; Exposure-levels
Cancer Epidemiology, Biomarkers & Prevention