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Carcinogenesis Advance Access published online on November 25, 2005
Carcinogenesis, doi:10.1093/carcin/bgi284
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© The Author 2005. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org
Received September 13, 2005
Revised November 15, 2005
Accepted November 20, 2005

MOLECULAR EPIDEMIOLOGY AND CANCER PREVENTION

Concordance of multiple analytical approaches demonstrates a complex relationship between DNA repair gene SNPs, smoking, and bladder cancer susceptibility

Angeline S. Andrew 1 *, Heather H. Nelson 2, Karl T. Kelsey 3, Jason H. Moore 4, Alexis C. Meng 4, Daniel P. Casella 1, Tor D. Tosteson 1, Alan R. Schned 5, and Margaret R. Karagas 1

1 Department of Community and Family Medicine, Section of Biostatistics and Epidemiology, Dartmouth Medical School, Lebanon, NH 03756
2 Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115
3 Department of Genetics and Complex Diseases, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115
4 Department of Genetics, Computational Genetics Laboratory, Dartmouth Medical School, Lebanon, NH 03756
5 Department of Pathology, Dartmouth Medical School, Lebanon, NH 03756

* To whom correspondence should be addressed.
Angeline S. Andrew, E-mail: Angeline.Andrew{at}dartmouth.edu


  Abstract

Study results of single nucleotide polymorphisms (SNPs) and cancer susceptibility are often conflicting, possibly because of the analytic challenges of testing for multiple genetic and environmental risk factors using traditional analytic tools. We investigated the relationship between DNA repair gene SNPs, smoking, and bladder cancer susceptibility in 355 cases and 559 controls enrolled in a population-based study of bladder cancer in the US. Our multifaceted analytical approach included logistic regression, multifactor dimensionality reduction (MDR), and hierarchical interaction graphs for the analysis of gene-gene and gene-environment interactions followed by linkage disequilibrium and haplotype analysis. Overall, we did not find an association between any single DNA repair gene SNP and bladder cancer risk. We did find a marginally significant elevated risk of the XPD codon 751 homozygote variant among never smokers (adjusted OR 2.5 95% CI (1.0-6.2)). In addition, the XRCC1 194 variant allele was associated with a reduced bladder cancer risk among heavy smokers (adjusted OR 0.4 95%CI (0.2-0.9)). The best predictors of bladder cancer included the XPD codon 751 and 312 SNPs along with smoking. Interpretation of this multifactor model revealed that the relationship between the XPD SNPs and bladder cancer is mostly non-additive while the effect of smoking is mostly additive. Since the two XPD SNPs are in significant linkage disequilibrium (D'=0.52, p=0.0001), we estimated XPD haplotypes. Individuals with variant XPD haplotypes were more susceptible to bladder cancer (e.g. adjusted OR 2.5 95%CI (1.7-3.6)) and the effect was magnified when smoking was considered. These results support the hypothesis that common polymorphisms in DNA repair genes modify bladder cancer risk and emphasize the need for a multifaceted statistical approach to identify gene-gene and gene-environment interactions.

Keywords: DNA repair; bladder cancer; polymorphism; interaction.
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