Biological effect markers for exposure to carcinogenic compound and their relevance for risk assessment

In this review data are summarized on biomarkers that are used for biological effect monitoring of human populations exposed to genotoxic carcinogens. The biomarkers are DNA and protein adducts and cytogenetic effects. Most of these biomarkers are relevant for the process of carcinogenesis. Emphasis is on providing information on the properties of the biomarkers and on their relevance for predicting cancer risk. Overviews are presented of: (1) studies on effects of exposure in target tissues of human origin obtained by surgical biopsies or autopsies, (2) epidemiological studies on healthy (cancer-free) individuals, correlating the putative occupational, lifestyle or environmental exposure with increased levels of biomarkers in blood cells, and (3) studies with animal models on the relation between biomarkers and cancer. Finally, on the basis of epidemiological data the possibilities were explored to use biomarker data to estimate the risk of death due to cancer. For several biomarkers the increment of the cancer mortality risk was calculated on the basis of a lifetime doubling of the biomarker level.