Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance

Barbiero, Fabiano; Zanin, Tina; Pisa, Federica Edith; Casetta, Anica; Rosolen, Valentina; Giangreco, Manuela; Negro, Corrado; Bovenzi, Massimo; Barbone, Fabio

doi:10.1007/s00420-018-1326-3

Cited by 8 publications

(12 citation statements)

References 19 publications

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“…A higher mortality risk of 1.68 (95% CI: 1.19–2.30) was found in the Polish cohort of workers compensated for asbestosis, 19 and in two Italian cohorts 16,17 . The SIR of 1.61 (95% CI: 1.26–2.04) in one of the Italian cohorts was slightly higher than our risk estimate 15 . In our previous German surveillance cohort study we observed a decreased lung cancer mortality of 0.39 (95% CI: 0.17–0.77) 12 .…”

Section: Discussioncontrasting

confidence: 82%

“…For lung cancer we observed a much lower SIR of 1.27 than for mesothelioma. A higher mortality risk of 1.68 (95% CI: 1.19–2.30) was found in the Polish cohort of workers compensated for asbestosis, 19 and in two Italian cohorts 16,17 . The SIR of 1.61 (95% CI: 1.26–2.04) in one of the Italian cohorts was slightly higher than our risk estimate 15 .…”

Section: Discussioncontrasting

confidence: 78%

“…Some of these did not include subjects with known asbestosis or benign asbestos-related diseases and also found elevated risks for mesothelioma. [15][16][17] The standard mortality ratio of 25 in a cohort of asbestos cement workers was slightly higher than the SIR in our study. 17 Other studies focused on the subjects' asbestosis or benign pleural disease, 12,18 on cohorts with subjects with or without asbestosis or benign pleural diseases, 12 or on workers compensated for asbestosis.…”

Section: Discussioncontrasting

confidence: 75%

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Lung cancer and mesothelioma risks in a prospective cohort of workers with asbestos‐related lung or pleural diseases

Taeger

Wichert

Lehnert

et al. 2022

American J Industrial Med

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Background Asbestos causes mesothelioma and lung cancer. In the European Union, asbestos was banned in 2005, but it is still in use in many other countries. The aim of this study was to estimate the lung cancer and mesothelioma incidence risk of men with benign asbestos‐related lung or pleural diseases. Methods Between 2008 and 2018, 2439 male participants of a German surveillance program for asbestos workers were included in the cohort. All participants had a recognized occupational asbestos‐related disease of the pleura or lung. We estimated the mesothelioma and lung cancer risks by calculating standardized incidence ratios (SIR) with corresponding 95% confidence intervals (95% CI). Results We observed 64 incident lung cancer and 40 mesothelioma cases in the cohort. An SIR of 17.60 (95% CI: 12.57–23.96) was estimated for mesothelioma and 1.27 (95% CI: 0.98–1.62) for lung cancer. The presence of pleural plaques was associated with a strongly increased risk (SIR: 13.14; 95% CI: 8.51–19.40) for mesothelioma, but not for lung cancer (SIR: 1.05; 95% CI: 0.76–1.41). The highest lung‐cancer risk (SIR: 2.56; 95% CI 1.10–5.04) was revealed for cohort members with less than 40 years since first asbestos exposure. Lung cancer risks by duration of asbestos exposure did not show a consistent time trend, but for time since last exposure a trend for mesothelioma was seen. Conclusions Compared to the general population, we demonstrated an association between benign asbestos‐related lung or pleural disease and mesothelioma risk in workers with a history of occupational asbestos exposure. Because lung‐cancer risk is dominated by smoking habits, a possible effect of asbestos exposure may have been masked. Efforts should be made to ban production and use of asbestos worldwide and to establish safe handling rules of legacy asbestos.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 78%

Section: Discussioncontrasting

confidence: 75%

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Lung cancer and mesothelioma risks in a prospective cohort of workers with asbestos‐related lung or pleural diseases

Taeger

Wichert

Lehnert

et al. 2022

American J Industrial Med

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“…A more prominent magnitude of relative risk of male gastric cancer, with SMR = 1.91 (95% CI 1.03–3.56), can be noted in the subgroup sample of occupational cohorts in China and Russia. Barbiero et al reported a borderline increased incidence found for gastric cancer (SIR = 1.53, 95% CI 0.96–2.31) in an Italian cohort enrolled in a public health surveillance program [ 24 ]. A case of gastric cancer was recognized as work-related disease in a 57-year-old Korean man who had continuous exposure to high levels of asbestos for 40 years [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Gastric Cancer in Asbestos-Exposed Workers: A Retrospective Cohort Study Based on Taiwan Cancer Registry 1980–2015

Fang

Chuang

Pan

et al. 2021

IJERPH

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Asbestos has been recognized as a human carcinogen associated with malignant mesothelioma, cancers of lung, larynx, and ovary. However, a putative association between gastric cancer and asbestos exposure remains controversial. In this study, we aimed to explore gastric cancer risk of workers potentially exposed to asbestos in Taiwan. The asbestos occupational cohort was established from 1950 to 2015 based on the Taiwan Labor Insurance Database, and Taiwan Environmental Protection Agency regulatory datasets, followed by the Taiwan Cancer Registry for the period 1980–2015. Standardized incidence ratios (SIRs) for cancer were computed for the whole cohort using reference rates of the general population, and also reference labor population. Compared with the general population, SIR of the asbestos occupational cohort for the gastric cancer increased both in males (1.05, 95% confidence interval (CI): 1.02–1.09) and females (1.10, 95% CI: 1.01–1.18). A total of 123 worksites were identified to have cases of malignant mesothelioma, where increased risk for gastric cancer was found with a relative risk of 1.76 (95% CI: 1.63–1.90). This 35-year retrospective cohort study of asbestos-exposed workers in Taiwan may provide support for an association between occupational exposure to asbestos and gastric cancer.

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“…Other studies found relatively lower ratios of LC to MPM deaths and incidence: about 3 to 1 and 2 to 1, respectively. 10,11 Applying the same proportions to Monfalcone shipyard workers would lead to crude estimates of between 340 and 680 expected LC cases. If the above assumptions hold, only about 20% to 40% of all LC cases have been reported to the public prosecution office and have undergone autopsy, reducing considerably the size and power of our study and creating the potential for selection of the included cases.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of lung cancer: a necropsy-based study of 128 cases (1997–2016)

Barbieri¹,

Mirabelli

2020

Tumori

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Background: The diagnosis of lung cancer (LC) may be difficult to make in the elderly. We report on the diagnostic elements available in life in an LC necropsy case series of asbestos-exposed workers and describe the frequency of non-neoplastic asbestos-related diseases as biological exposure indices. Methods: We reviewed pathologic and clinical records of an unselected series of autopsies (1997–2016) in patients with LC employed in the Monfalcone shipyards. We assessed the consistency with autopsy results of diagnoses based on, respectively, radiologic, cytologic, and histologic findings. Results: Data on 128 autopsy-confirmed LC cases were available; in life, 119 had been diagnosed as LC. Among these, 49 had histologic confirmation of diagnosis (17 with immunophenotyping); histology had been negative in 4. Cytology had been the main positive finding and the basis for diagnosis in 24 cases, but had been negative in 13. Chest computed tomography had been the basis for diagnosis in 45; in 18 cases, it had been negative. Nine patients had received a diagnosis different from LC, among whom 4 had been suspected to have malignant pleural mesothelioma by chest computed tomography. Pleural plaques were found in 124 and histologic asbestosis in 46 cases. Conclusions: Autopsies confirmed all LC diagnoses received in life, including 46 that would have been considered only possible LC based on clinical workup. The overall survival in this case series was poor. The high prevalence of pleural plaques and asbestosis suggest severity of asbestos exposures.

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Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance

Abstract: This cohort experienced an excess in the incidence of both mesothelioma and lung cancer, showing increasing incidence rates at higher level of asbestos exposure. For lung cancer, the relative incidence was highest among workers hired in shipbuilding between 1974 and 1984.

Cited by 8 publications

References 19 publications

Lung cancer and mesothelioma risks in a prospective cohort of workers with asbestos‐related lung or pleural diseases

Lung cancer and mesothelioma risks in a prospective cohort of workers with asbestos‐related lung or pleural diseases

Increased Risk of Gastric Cancer in Asbestos-Exposed Workers: A Retrospective Cohort Study Based on Taiwan Cancer Registry 1980–2015

Diagnosis of lung cancer: a necropsy-based study of 128 cases (1997–2016)

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