Blood Telomere Length Attrition and Cancer Development in the Normative Aging Study Cohort

EBioMedicine. 2015 Apr 13;2(6):591-6. doi: 10.1016/j.ebiom.2015.04.008. eCollection 2015 Jun.


Background: Accelerated telomere shortening may cause cancer via chromosomal instability, making it a potentially useful biomarker. However, publications on blood telomere length (BTL) and cancer are inconsistent. We prospectively examined BTL measures over time and cancer incidence.

Methods: We included 792 Normative Aging Study participants with 1-4 BTL measurements from 1999 to 2012. We used linear mixed-effects models to examine BTL attrition by cancer status (relative to increasing age and decreasing years pre-diagnosis), Cox models for time-dependent associations, and logistic regression for cancer incidence stratified by years between BTL measurement and diagnosis.

Findings: Age-related BTL attrition was faster in cancer cases pre-diagnosis than in cancer-free participants (pdifference = 0.017); all participants had similar age-adjusted BTL 8-14 years pre-diagnosis, followed by decelerated attrition in cancer cases resulting in longer BTL three (p = 0.003) and four (p = 0.012) years pre-diagnosis. Longer time-dependent BTL was associated with prostate cancer (HR = 1.79, p = 0.03), and longer BTL measured ≤ 4 years pre-diagnosis with any (OR = 3.27, p < 0.001) and prostate cancers (OR = 6.87, p < 0.001).

Interpretation: Age-related BTL attrition was faster in cancer cases but their age-adjusted BTL attrition began decelerating as diagnosis approached. This may explain prior inconsistencies and help develop BTL as a cancer detection biomarker.

Keywords: Cancer incidence; Longitudinal study; Telomere.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Biomarkers, Tumor
  • Cohort Studies
  • Humans
  • Leukocytes / physiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / physiopathology*
  • Prospective Studies
  • Telomere / physiology*
  • Telomere Homeostasis / physiology*
  • Telomere Shortening / physiology*


  • Biomarkers, Tumor