For those of you keeping track at home, I’ve been about six weeks without a cigarette during this latest quit attempt. Instead of smoking, I’ve developed the cross-addiction of obsessively reading the latest medical research about all the different ways in which smoking will kill you. This gives me a sense of relief that can, in a pinch, keep the cravings at bay.

And smugness. Smugness gives you a good buzz.

One of these recent studies caught my eye last week. Researchers at the University of Minnesota, writing in Cancer Research, described work that could lead to a urine test to identify smokers at a high risk of developing lung cancer.

Briefly, the group led by Jian-Min Yuan harvested data from two Chinese cohorts that included over 80,000 patients. Urine and blood samples were collected at the time of the study (about 20 years ago) and the participant answered a set of questions, including some regarding their smoking habits. For the Cancer Research paper, Yuan and his colleagues focused on about 250 smokers who had developed lung cancer and an equal number of smokers who did not.

They tested frozen urine from these sample sets for the levels of NNAL, a metabolite that has been shown to cause lung cancer in rats. Smokers who had the highest levels of NNAL present in their urine had an 8.5-fold increase in the risk of lung cancer compared with smokers with the lowest levels.

Yuan, in an interview with WebMD, said: “The idea is to build up a risk model that incorporates many of these biomarkers as well as smoking history, so we can best identify which smokers will eventually develop lung cancer.”

In other words, the ultimate goal would be a simple test that could be administered to smokers to determine their risk for lung cancer.

(As a brief aside, I learned from reading this paper that only 10 – 16% of smokers actually die from lung cancer*. A statistic to which my inner addict said, “Pretty good odds, let’s go have a smoke.”)

It was less the science of this particular paper that got my attention than the societal implications. If, as a smoker, your GP could tell you that you would definitely develop lung cancer soon, would you quit? How embedded is the denial?

Another issue that isn’t clear is that once these metabolites are detected, is there any hope of reversal? If your test reveals that you are highly likely to develop lung cancer, would quitting at that point do anything to change your fate?

It isn’t just lung cancer that medical researchers are working out ways to detect. There are currently more than 1,000 genetic tests available for early detection of diseases and hereditary conditions. If you had the inclination, time and money you could be tested for diseases ranging from Amyotrophic lateral sclerosis to Timothy Syndrome, with stops at Charcot-Marie-Tooth, Huntington’s Disease and Duchenne’s Muscular Dystrophy in between.

The question is: would you want to be?

Would you want to know, for example, in your mid-30’s that you were genetically predisposed to Alzheimers? As a teenage girl, would you want to know your chances of developing breast cancer? Bearing in mind that most of these diseases are incurable, would you really want to know? Bearing in mind that in most cases these tests do not determine whether or not you will develop the disease but whether or not you are genetically predisposed to do so. 

How about a different question – what about your kids? If you were an expectant parent would you want to know if your child was likely to develop Fragile X syndrome or Duchenne’s Muscular Dystrophy?* What about if the tests could be done at an early stage of pregnancy?

It’s a different kettle of fish isn’t it?

Don’t get me wrong, I think genetic testing is a fantastic scientific advance and in a lot of cases is an essential diagnostic tool. But as the technology becomes cheaper and more readily available (I could test your likelihood of developing some types of breast cancer before lunch) and in the absence of any effective ‘cure’ for most of the diseases or conditions that can be detected are we just providing another source of anxiety for our already anxious species?

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* Yes, I know that lung cancer is only one of the things about smoking that will kill you. Yes, I know about emphysema, heart disease and on and on. But I could still murder a cigarette.

** For the record, I would say ‘no’ to the first set of questions and ‘yes’ to the second.

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My female vocal jazz kick continues. Nobody has ever sung this song better than The High Priestess of Soul. Check out the “Ultimate Nina Simone” from Nina Simone - Ultimate Nina Simone.

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I could kill a human…

Cigarette lungs

Genetic testing

 
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