We review the experimental evidence for various shapes of dose-response relationships for carcinogens and summarize those experiments that give the most information on relatively low doses. A brief review of some models is given to illustrate the shapes of dose-response curve expected from them. Our major interest is in the use of dose-response relationships to estimate risks to humans at low doses, and so we pay special attention to experimentally observed and theoretically expected nonlinearities. There are few experimental examples of nonlinear dose-response relations in humans, but this may simply be due to the limitations in the data. The several examples in rodents, even though for high dose data, suggest that nonlinearity is common. In some cases such nonlinearities may be rationalized on the basis of the pharmacokinetics of the test compound or its metabolites.
IntroductionThe primary reason for the authors' interest in doseresponse relationships for carcinogens is the need to estimate human risks at low doses. Typically, the only data available are the results of animal experiments at high doses, perhaps augmented by scanty epidemiological information (together with test results from a battery of short-term tests, which are not considered further here). Conclusive demonstration of the existence or nonexistence of certain aspects of dose-response relationships for carcinogens would greatly ease the task of risk assessment, in turn making regulation of carcinogens, and the explanation of such regulation, simpler. For example, if a threshold dose, below which there is no response, exists, then exposure up to that threshold would clearly pose no risk. Evidently, there are many other reasons for study of dose-response relationships at all doses, but in this review we concentrate on the lowest doses that give experimentally measurable response. In particular, we are interested in the extent to which measurable dose-response curves for cancers .deviate from linearity.This review surveys the relevant human ("Human Studies") and whole animal ("Animal Studies") experimental data on carcinogenesis at relatively low doses, with an outline of theories that have been advanced and remain consistent with this data ("Dose-Response For- mulae"). Of special interest are the observed nonlinearities in dose-response relationships, and the possible explanations for them.Most models of the cancer process are constructed by describing (mathematically) a set of elementary biological processes which are supposed to be fundamental. The effect of doses of carcinogens on these elementary processes is generally assumed to be the simplest possible (e.g., described by a chemical reaction rate), but the dose-response relationship for the whole model will usually be as arbitrary as the assumptions made for these elementary processes. Many of the mathematical models suggested are expressions of the biological idea of a multistage process. We demonstrate how many different dose-response formulae can be obtained within this one framework, ...