ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2020
Urinary Cotinine Is as Good a Biomarker as Serum Cotinine for Cigarette Smoking Exposure and Lung Cancer Risk Prediction.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Predictive performance of risk prediction models for lung cancer incidence in Western and Asian countries: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Cotinine Promotes Cancer Cell Proliferation and mEnvironment & health (Washington, D.C.) · 2026Article
- The association between urine cotinine level and hemoglobin and hematocrit levels: a cross-sectional study using the Korea National Health and Nutrition Examination Survey VIII (2019-2021).Korean journal of family medicine · 2026Article
- Urinary Volatilomic Signatures for Non-Invasive Detection of Lung Cancer: A HS-SPME/GC-MS Proof-of-Concept Study.International journal of molecular sciences · 2026Article
- Association of food insecurity with the use of tobacco products and urine cotinine-measured smoking intensity: evidence from a population-based study in South Korea, 2019-2021.Tobacco control · 2026Article
- A Meta-Analysis of Urinary Cotinine Cut-Off Concentrations in Children Under Five Years for Assessing Environmental Tobacco Smoke Exposure.Tobacco use insights · 2026Review
- Self-reported smoking, urine cotinine, and risk of incident hypertension: findings from the PREVEND prospective cohort study.Journal of human hypertension · 2025Article
- Characterizing oxidative metabolites of 6-methylnicotine (6MN; aka Metatine): divergent metabolism from nicotine and identification of urinary biomarkers of exposure.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Recommendations for sample selection, collection and preparation for NMR-based metabolomics studies of blood.Metabolomics : Official journal of the Metabolomic Society · 2025Review
- Prenatal polycyclic aromatic hydrocarbons exposure and child growth and adiposity: A longitudinal study.Environmental research · 2025Article
- Secondhand smoke exposure and behavioral problems in Japanese schoolchildren.Frontiers in public health · 2025Article
- Trends in NHANES Biomonitored Exposures in California and the United States following Enactment of California's Proposition 65.Environmental health perspectives · 2024Article
- Serum cotinine levels and adolescents' sleep health outcomes from NHANES 2005 to 2018.Scientific reports · 2024Article
- Plasma nicotine and its metabolite as biomarkers of tobacco exposure and their relevance to pulmonary nodule.Biomarkers in medicine · 2024Article
- Leukemia risk assessment of exposure to low-levels of benzene based on the linearized multistage model.Frontiers in public health · 2024Article
- Association of Urinary Biomarkers of Smoking-Related Toxicants with Lung Cancer Incidence in Smokers: The Multiethnic Cohort Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Multiomic Approaches for Cancer Biomarker Discovery in Liquid Biopsies: Advances and Challenges.Biomarker insights · 2023Review
- Interaction between serum cotinine and body mass index on asthma in the children: a cross-sectional study.BMC pediatrics · 2022Article
- Noninvasive systemic biomarkers of e-cigarette or vaping use-associated lung injury: a pilot study.ERJ open research · 2022Article
- Exposure and Risk Assessment of Second- and Third-Hand Tobacco Smoke Using Urinary Cotinine Levels in South Korea.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundCotinine is a metabolite of nicotine. Serum and urinary cotinine are validated biomarkers for cigarette exposure. Their performance for lung cancer risk prediction has not been simultaneously examined in epidemiologic studies.
methodsA nested case-control study, including 452 incident lung cancer cases and 452 smoking-matched controls in the Shanghai cohort study, was conducted. Mass spectrometry-based methods were used to quantify cotinine in serum and urine samples collected from current smokers at baseline, on average 10 years before cancer diagnosis of cases. Logistic regression was used to estimate ORs, 95% confidence intervals (CI), and AUC ROC for lung cancer associated with higher levels of cotinine.
resultsSerum and urinary cotinine levels were significantly higher in lung cancer cases than controls. Compared with the lowest quartile serum cotinine (≤0.40 nmol/mL), the OR of lung cancer for smokers in the highest quartiles (>1.39 nmol/mL) was 5.46 (95% CI, 3.38-8.81). Similarly, the OR was 5.49 (95% CI, 3.39-8.87) for highest (>16.38 nmol/mg creatinine) relative to the lowest quartile of urinary total cotinine (≤4.11 nmol/mg creatinine). A risk prediction model yielded an AUC of 0.72 (95% CI, 0.69-0.75) for serum cotinine and 0.72 (95% CI, 0.69-0.75) for urinary total cotinine combined with smoking history.
conclusionsUrinary and serum cotinine have the same performance in prediction of lung cancer risk for current smokers. IMPACT: Urinary cotinine is a noninvasive biomarker that can replace serum cotinine in risk prediction of future lung cancer risk for current smokers.
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