Asbestos‐related lung cancer: Clinical characteristics and survival outcomes in an Australian cohort seeking workers compensation

Abstract

Background and objectives: Due to difficulties in identifying sufficient-sized cohorts there remains uncertainty about prognostic and clinical differences that may be unique to asbestos-related lung cancer (ARLC). In this study, we use the Helsinki Criteria to define a group of ex-workers with lung cancer attributable to asbestos exposure and investigate differences that may exist.Methods: A total of 529 patients seeking workers' compensation for their lung cancer were assigned to either ARLC or the non-ARLC based on parameters defined in the Helsinki Criteria. Clinical and survival details were collected and analyzed.Results: In our study population, ARLC patients were on average older (72.1 ± 7.8) than non-ARLC patients (66.5 ± 10.2, P < 0.001) and were more likely to be diagnosed as a result of incidental findings or screening program (P < 0.001). The groups were similar in terms of clinical characteristics with the only difference being that plaques were more prevalent among ARLC patients (P < 0.001). Differences were observed for median overall survival (OS), ARLC (9 months) and non-ARLC (13 months, P = 0.005), as well for treatment (P = 0.01). After adjusting for age, however, these differences disappeared.Conclusions: Age at diagnosis, pleural plaques, and asymptomatic presentation were the attributes that we identified as significantly different between asbestos-related cancer and other lung cancers. In this cohort, ARLC patients were older diagnosis and with worse overall survival.

Clinical investigation of former workers exposed to asbestos: the health surveillance experience of an Italian University Hospital

“…It is known that the combined effect of exposure to asbestos and tobacco smoke on lung cancer risk is more than additive and close to multiplicative; therefore, there is no scientific basis for contrasting these two factors in the risk assessment for individuals with both exposures (12, 48-51). We also observed that the majority of patients with lung cancer associated with asbestosis received a late diagnosis of cancer due to asbestosis-induced masking of symptoms (52). With reference to the occupations and respective production sectors of the 20 detected cases of lung cancer, our data agree with the recent meta-analysis on the impact of occupational exposure to asbestos on lung cancer in Italy (53).…”

Non‐small cell lung cancer in China

“…Radiation promoted the overexpression of oncogenes and the inactivation of tumor suppressor genes, thus leading to the occurrence and progression of lung cancer [58,59]. Lung cancer-related occupational exposure included asbestos, methyl chloride, chromium, nickel, and polycyclic aromatic hydrocarbons (PAHs) [60][61][62][63][64][65]. In a Chinese cohort involving 2,346 cases, Liu et al [64] found that exposure to occupational carcinogens was higher in areas with high/middle prevalence of lung cancer than in lowprevalence areas (58.02%-65.83% vs. 38.57%, respectively).…”

“…Radiation promoted the overexpression of oncogenes and the inactivation of tumor suppressor genes, thus leading to the occurrence and progression of lung cancer [ 58 , 59 ]. Lung cancer‐related occupational exposure included asbestos, methyl chloride, chromium, nickel, and polycyclic aromatic hydrocarbons (PAHs) [ 60 , 61 , 62 , 63 , 64 , 65 ]. In a Chinese cohort involving 2,346 cases, Liu et al.…”