Association between urinary benzotriazole ultraviolet stabilizers and lung cancer risk: A case-control study

As emerging environmental contaminants with suspected human health impacts, benzotriazole ultraviolet stabilizers (BUVSs) lack empirical evidence regarding pulmonary carcinogenicity in exposed populations, highlighting the need to investigate their potential association with lung cancer. This study aimed to analyze the relationship between urinary BUVSs concentrations and lung cancer risk within the general population of Hangzhou, China. This case-control study included 397 newly diagnosed lung cancer patients and an equivalent cohort of age- and sex-matched healthy controls. Urine samples were analyzed for five different types of BUVSs, with total concentrations ranging from 0.46 to 36.40 μg/g creatinine. 2-(2’-Hydroxy-3’,5’-di-tert-butylphenyl)-5-chloro-benzotriazole (UV-327) was the most prevalent, with a mean concentration of 5.09 μg/g creatinine. Logistic regression models were employed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for assessing lung cancer risk in relation to urinary BUVSs concentrations. Following adjustment for covariates including sex, smoking status, alcohol intake, and dietary habits, urinary 2-(2H-benzotriazol-2-yl)- p -cresol (UV-P) was the only BUVS demonstrating a significant correlation with lung cancer risk. Participants in the highest urinary UV-P concentration group exhibited a 4.5-fold higher risk of lung cancer relative to those in the lowest group (adjusted OR=4.55, 95% CI:2.84–7.28, p for trend < 0.01). The link between elevated UV-P exposure and a higher risk of lung cancer was affected by factors such as smoking status and dietary habits. These findings provide novel evidence of a potential association between BUVSs exposure—particularly UV-P—and lung cancer in the general Chinese population, and highlight the need for future longitudinal and mechanistic studies to confirm these associations and elucidate the underlying biological pathways.