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American Journal of Epidemiology Advance Access originally published online on February 12, 2008
American Journal of Epidemiology 2008 167(7):759-774; doi:10.1093/aje/kwm383
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Glutathione S-Transferase M1 (GSTM1) Polymorphisms and Lung Cancer: A Literature-based Systematic HuGE Review and Meta-Analysis

C. Carlsten1,2, G. S. Sagoo3,4, A. J. Frodsham3,4, W. Burke5,6 and J. P. T. Higgins3,4

1 Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
2 School of Environmental Health, University of British Columbia, Vancouver, British Columbia, Canada
3 United Kingdom HuGENet Coordinating Centre, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom
4 MRC Biostatistics Unit, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
5 Department of Medicine, School of Medicine, University of Washington, Seattle, WA
6 Center for Ecogenetics and Environmental Health, University of Washington, Seattle, WA

Correspondence to Dr. Chris Carlsten, Vancouver General Hospital, 2775 Laurel Street, 7th Floor (The Lung Center), Vancouver, British Columbia V5Z 1M9, Canada (e-mail: chris.carlsten{at}vch.ca).

Received for publication July 5, 2007. Accepted for publication December 7, 2007.

Multiple genes have been studied for potential associations with lung cancer. The gene most frequently associated with increased risk has been glutathione S-transferase M1 (GSTM1). The glutathione S-transferase enzyme family is known to catalyze detoxification of electrophilic compounds, including carcinogens, therapeutic drugs, environmental toxins, and products of oxidative stress. In this review, the authors summarize the available evidence associating lung cancer with the GSTM1 gene. They describe results from an updated meta-analysis of 98 published genetic association studies investigating the relation between the GSTM1 null variant and lung cancer risk including 19,638 lung cancer cases and 25,266 controls (counting cases and controls in each study only once). All studies considered, the GSTM1 null variant was associated with an increased risk of lung cancer (odds ratio (OR) = 1.22, 95% confidence interval (CI): 1.14, 1.30), but no increase in risk was seen (OR = 1.01, 95% CI: 0.91, 1.12) when only the five largest studies (>500 cases each) were considered. Furthermore, while GSTM1 null status conferred a significantly increased risk of lung cancer to East Asians (OR = 1.38, 95% CI: 1.24, 1.55), such a genotype did not confer increased risk to Caucasians. More data regarding the predictive value of GSTM1 genetic testing are needed before population-based testing may be reasonably considered.

epidemiology; genetics; genome; human; glutathione S-transferase M1; glutathione transferase; GSTM1; lung neoplasms; meta-analysis

Abbreviations: CI, confidence interval; CYP, cytochrome P-450; CYP1A1, cytochrome P-450 1A1; GST, glutathione S-transferase; GSTM1, glutathione S-transferase M1; GSTT1, glutathione S-transferase T1; HuGE, Human Genome Epidemiology; HuGENet, Human Genome Epidemiology Network; OR, odds ratio

Editor's note: This article also appears on the website of the Human Genome Epidemiology Network (http://www.cdc.gov/genomics/hugenet/).


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