Serum trace-element categories and reported first-degree family history of malignancy: an exploratory analysis of the SPES cohort
- 1Department of Public Health, University of Naples Federico II
- 2Department of Health and Health Services, Regione Calabria
- 3Department of Human Sciences and Quality of Life Promotion, San Raffaele University
Abstract
Background: We examined whether contemporary serum trace-element categories were associated with reported first-degree family history of malignancy, rather than a relative’s historical exposure or the participant’s future cancer risk.
Methods: This secondary exploratory cross-sectional analysis used archived data from 4,188 adults in SPES (Studio di Esposizione nella Popolazione Suscettibile), a population-based human-biomonitoring programme conducted in Campania, Italy, in 2016–2017. Relative-level reports were classified using documented rules and oncologist adjudication; a second registered physician independently reviewed a random 760-record subsample in a post hoc assessment during revision. Principal mixed-effects logistic models used observed median categories for 18 channels and quantified-versus-below-limit-of-quantification status for Be-9 and Pb-208, adjusting for age modelled with a restricted cubic spline, sex, participant smoking and SPES cluster. The 20 channels represented 19 elements. The original analysis inventory contained 258 hypothesis slots across nine separately corrected families; reviewer-requested sensitivities were reported separately.
Results: Family history was positive in 1,040 of 4,185 classifiable participants (24.9%). Principal odds ratios ranged from 0.832 to 1.109 (minimum q = 0.730). Original upper-quartile and conditional malignancy-category findings did not survive their respective corrections. Category models compared a target malignancy with other malignancies among composite-positive histories, with incomplete site ascertainment. Additional stratum-adjusted, expanded-adjustment, quantified-range, broader-comparator and restrictive-definition principal/category families yielded no FDR-supported association. Cobalt met the within-set BH criterion only in a selected three-contrast expanded-Q4 sensitivity ( q = 0.019), not a panel-wide analysis. Independent binary agreement was 99.87% (757/758; κ = 0.9969); two indeterminate ratings were reported separately.
Conclusion: The tested serum categories did not identify a broad reported first-degree family-history signature. Nominal secondary patterns are hypotheses for independent replication, not validated exposure–cancer relationships. Classification reproducibility does not establish diagnostic accuracy or registry confirmation.
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BibTeX
@article{buonerba2026serum,
title = {{Serum trace-element categories and reported first-degree family history of malignancy: an exploratory analysis of the SPES cohort}},
author = {Carlo Buonerba and Paolo Montuori and Ernesto Esposito and Maria Triassi and Pellegrino Cerino},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1958224},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1958224/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Serum trace-element categories and reported first-degree family history of malignancy: an exploratory analysis of the SPES cohort
AU - Carlo Buonerba
AU - Paolo Montuori
AU - Ernesto Esposito
AU - Maria Triassi
AU - Pellegrino Cerino
PY - 2026
DA - 2026/11/09
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1958224
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1958224/full
AB - Background: We examined whether contemporary serum trace-element categories were associated with reported first-degree family history of malignancy, rather than a relative’s historical exposure or the participant’s future cancer risk. Methods: This secondary exploratory cross-sectional analysis used archived data from 4,188 adults in SPES (Studio di Esposizione nella Popolazione Suscettibile), a population-based human-biomonitoring programme conducted in Campania, Italy, in 2016–2017. Relative-level reports were classified using documented rules and oncologist adjudication; a second registered physician independently reviewed a random 760-record subsample in a post hoc assessment during revision. Principal mixed-effects logistic models used observed median categories for 18 channels and quantified-versus-below-limit-of-quantification status for Be-9 and Pb-208, adjusting for age modelled with a restricted cubic spline, sex, participant smoking and SPES cluster. The 20 channels represented 19 elements. The original analysis inventory contained 258 hypothesis slots across nine separately corrected families; reviewer-requested sensitivities were reported separately. Results: Family history was positive in 1,040 of 4,185 classifiable participants (24.9%). Principal odds ratios ranged from 0.832 to 1.109 (minimum q = 0.730). Original upper-quartile and conditional malignancy-category findings did not survive their respective corrections. Category models compared a target malignancy with other malignancies among composite-positive histories, with incomplete site ascertainment. Additional stratum-adjusted, expanded-adjustment, quantified-range, broader-comparator and restrictive-definition principal/category families yielded no FDR-supported association. Cobalt met the within-set BH criterion only in a selected three-contrast expanded-Q4 sensitivity ( q = 0.019), not a panel-wide analysis. Independent binary agreement was 99.87% (757/758; κ = 0.9969); two indeterminate ratings were reported separately. Conclusion: The tested serum categories did not identify a broad reported first-degree family-history signature. Nominal secondary patterns are hypotheses for independent replication, not validated exposure–cancer relationships. Classification reproducibility does not establish diagnostic accuracy or registry confirmation.
SN - 2296-2565
ER -