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International Journal of Epidemiology 2007 36(1):23-28; doi:10.1093/ije/dym026
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.

Commentary: Reflections on G. M. Lower and colleagues’ 1979 study associating slow acetylator phenotype with urinary bladder cancer: meta-analysis, historical refinements of the hypothesis, and lessons learned

Nathaniel Rothman1,*, Montserrat Garcia-Closas1 and David W Hein2

1Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, MD20892, USA.
2Department of Pharmacology & Toxicology and James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY, USA.

*Corresponding author. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH EPS 8116, Bethesda, MD 20892, USA. E-mail: rothmann@mail.nih.gov

Keywords Bladder neoplasms, genetic susceptibility, NAT2, N-acetylation, tobacco

Accepted 5 February 2007

The first 150 words of the full text of this article appear below.

In 1979, Gerald Lower and colleagues published the first epidemiologic study to directly test the hypothesis that individuals exposed to aromatic amines would be at higher risk of urinary bladder cancer if they had the slow acetylator phenotype.1 Not only was the paper a landmark in the history of bladder cancer carcinogenesis, it was one of the very first efforts to study the effect of a metabolic polymorphism on risk for any cancer.

Lower began his paper1 by summarizing and integrating the empirical and conceptual basis for his hypothesis. After noting the initial observation of the bladder cancer excess among dye workers by Rehn in 1895,2 he described the key findings by investigators who had made seminal observations in the epidemiology of bladder cancer; performed the fundamental experimental studies of aromatic amine carcinogenesis; made the key clinical observations that the slow N-acetylation phenotype was associated with isoniazid neurotoxicity; carried out . . . [Full Text of this Article]


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