Carcinogen-DNA and carcinogen-protein adducts in molecular epidemiology.

Carcinogen-DNA and carcinogen-protein adducts provide an integrated measure of carcinogen exposure, uptake and absorption, metabolism, DNA repair and cell turnover. As such they promise to provide a more objective and relevant measure of exposure than that which can be derived from questionnaires and measures of ambient levels of carcinogen. Nevertheless, the interpretation of adduct measurements made in human tissues and body fluids requires an understanding of a number of factors. These include the sensitivity and specificity of the measurement, the temporal relationship between exposure and adduct level and the mechanistic role of the adduct in the process of carcinogenesis. The application of such biomarkers in epidemiological studies therefore necessitates careful consideration of optimal study design. The above issues are illustrated in this chapter with examples from studies in both animal models and human populations.