Transcriptional output in a prospective design conditionally on follow-up and exposure: the multistage model of cancer.

Transcriptomics as the analysis of mRNA and microRNA could be implemented in prospective studies both in peripheral blood and tissues. Its application in cancer epidemiology could provide a new understanding of the functional changes underlying the multistage model of carcinogenesis, as well as the relationship between these changes and exposure to carcinogens. Transcriptomics is not merely another -omics technology for risk assessment in traditional prospective studies. Instead, this novel approach has the potential to estimate the distribution of gene expression conditionally on different exposures, and to study the length of the different stages of carcinogenesis. If it proves to be a valid approach, transcriptomics could be an opportunity to make meaningful advances in our understanding of the carcinogenic process.