Comparative analysis of alpha-fetoprotein, carbohydrate antigen 19-9, carcinoembryonic antigen, and prostate-specific antigen among conventional cigarette smokers, heated tobacco product users and quitters

Abstract

Introduction: The association of Heated Tobacco Products (HTPs) use on cancerrelated biomarkers remains unclear. This study aimed to compare the levels of tumor markers, specifically alpha-fetoprotein (AFP), carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and prostate-specific antigen (PSA), between combustible cigarette (CC) smokers, any HTP users, and quitters.

Methods: This cross-sectional study compared tumor marker levels (AFP, CA 19-9, CEA, PSA) among 750 adult males: 250 CC smokers, 250 any HTP users, and 250 quitters. Data were collected from health screenings (2021–2022). Participants were aged >18 years with at least one year of smoking history.

Results: CEA was significantly higher in CC smokers (median: 2.4) than any HTP users (median: 2.0) and quitters (median: 1.6), with any HTP users exceeding quitters. PSA was higher in any HTP users (median: 0.86) than quitters (median: 0.74). No significant differences were observed in AFP and CA 19-9.

Conclusions: HTP users exhibit lower CEA levels compared to conventional cigarette smokers, yet their levels remain higher than those of quitters. Additionally, quitters were found to have lower PSA levels than HTP users. Further research is needed to determine the reasons for these differences.