Evidence map›Paper›PMID 42021368›Full record

ArticleClinical epigenetics2026

The association of epigenetic age acceleration with internal smoking dose, risk of lung cancer, and all-cause mortality in cigarette smokers: the Multiethnic Cohort study.

Tyler Liu, Lenora W M Loo, Brian Z Huang, Brandon Quon, Cherie Guillermo, Kimberly D Siegmund, Lynne R Wilkens, Alika K Maunakea, Stephen S Hecht, Sharon E Murphy and 4 more

Abstract read
In one paragraph

Article in Clinical epigenetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Tyler LiuJohn A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, USA.
Lenora W M LooCancer Biology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
Brian Z HuangDepartment of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.
Brandon QuonCancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
Cherie GuillermoCancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
Kimberly D SiegmundDepartment of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.
Lynne R WilkensCancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
Alika K MaunakeaJohn A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, USA.
Stephen S HechtDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
Sharon E MurphyDepartment of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, USA.
Daniel O StramDepartment of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.
Loïc Le MarchandCancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
Alexandra M BinderCancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
S Lani ParkCancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI, USA. lpark@cc.hawaii.edu.

Funding

University of Hawaii Cancer Center CCSGP30CA071789 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI Pallav Pokhrel · 1996 to 2026
$56.2M
Understanding Population Differences in Cancer: The MEC StudyU01CA164973 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI HAIMAN, CHRISTOPHER ALAN, LE MARCHAND, LOIC · 2015 to 2025
$37.4M
Untargeted Adductomics to Characterize Ethnic Differences in the Exposome of SmokersP01CA138338 · NCI · UNIVERSITY OF MINNESOTA · PI Daniel O Stram · 2010 to 2026
$33.4M
Multidisciplinary Training in Ethnic Diversity and Cancer DisparitiesT32CA229110 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI HAIMAN, CHRISTOPHER ALAN, LE MARCHAND, LOIC · 2019 to 2023
$2.1M
Integrating epidemiologic, clinical, genomic and metabolomic profiles to predict pancreatic cancer risk in a multiethnic populationR00CA256525 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI HUANG, BRIAN · 2023 to 2025
$747k
Integrating epidemiologic, clinical, genomic and metabolomic profiles to predict pancreatic cancer risk in a multiethnic populationK99CA256525 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI HUANG, BRIAN · 2021 to 2022
$240k
National Cancer Center P01CA138338NCI NIH HHS K99CA256525NCI NIH HHS P01 CA138338NCI NIH HHS P01CA138338NCI NIH HHS P30CA071789NCI NIH HHS R00CA256525NCI NIH HHS T32CA229110NCI NIH HHS U01CA164973
6 · The paper itself

Abstract

backgroundAmong cigarette smokers, higher internal smoking dose is associated with elevated lung cancer risk and mortality, independent of smoking pack-years. Some measures of epigenetic age acceleration (EAA) are associated with cigarette smoking status and exposure, as well as lung cancer risk and overall mortality. No study has examined the association between EAA measures and internal smoking dose (total nicotine equivalents (TNE; nmol/mL)), and their shared relationship with lung cancer incidence and mortality in a multiethnic population.

methodsFrom a subgroup of Multiethnic Cohort Study participants who smoked cigarettes at the time of biospecimen collection (n = 1969), six epigenetic clocks were computed using blood-based DNA methylation (DNAm) array data. EAA measures were computed by calculating the residuals that results from regressing an epigenetic clock on chronological age. The association of urinary TNE with EAA measures were assessed using linear regression models, adjusted for age, sex, body mass index (BMI; kg/m

resultsA standard deviation (SD) increase of log-TNE was statistically significantly associated with increased AgeAccelPheno (beta = 0.416, 95% Confidence Interval (CI)=0.134-0.698)), AgeAccelGrim (beta = 0.771, 95%CI=0.603-0.939), and DunedinPACE (beta = 0.015, 95%CI=0.010-0.020). A SD increase of AgeAccelGrim (Hazard Ratio (HR) = 1.40; 95% CI   1.16-1.71) and DunedinPACE (HR = 1.31; 95% CI  1.11-1.55) were associated with a risk of lung cancer, whereas a SD increase of AgeAccelDNAm-based telomere length was inversely associated with lung cancer risk (HR = 0.79; 95% CI  0.67-0.93). These findings were similar for the hazard of all-cause mortality.

conclusionsOur study suggests that circulating methylation-based biomarkers of biological aging may provide information on lung cancer risk and all-cause mortality beyond that of self-reported pack-years and a (short-term) biomarker of internal smoking dose. If replicated, our findings suggest that epigenetic clocks may inform higher risk groups for prevention strategies.

Indexed as

Cigarette SmokingEpigenesis, GeneticLung NeoplasmsSmokingAdultAgedAge FactorsCohort StudiesDNA MethylationEpigenomicsFemaleHumansMaleMiddle AgedNicotineRisk FactorsNicotineEpigenetic clocksLung cancerOverall mortalitySmokingTotal nicotine equivalents

Identifiers

PMID42021368
PMCPMC13251181

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.