Incidence of cancer among the participants of the Finnish Asbestos Screening Campaign

Abstract

Objectives Cancer risk has been estimated for asbestos production workers or other heavily exposed asbestos workers in numerous studies. The bulk of the asbestos epidemic results come, however, from past intermittent exposures during asbestos product use. This study concentrated on estimating the risk of cancer in such a population.Methods Altogether 23 285 men and 930 women invited to a nationwide screening campaign for benign asbestos-related diseases in 1990-1992 were followed for cancer through the Finnish Cancer Register up to 1998. Standardized incidence ratios (SIR) were calculated in comparison with the total Finnish population.Results Altogether 1392 cases of cancer were found among the men. The risk was slightly, but significantly elevated for lung cancer [SIR 1.14, 95% confidence interval (95% CI) 1.01-1.26), mesothelioma (SIR 2.77, 95% CI 1.66-4.31), and prostate cancer (SIR 1.21, 95% CI 1.09-1.34). The risk of lung cancer was slightly higher among the invited nonparticipants (SIR 1.48, 95% CI 1.20-1.79) than among the participants (SIR 1.02, 95% CI 0.88-1.17). About 98% of the lung cancers occurred in current or ex-smokers.Conclusions In a population of long-term construction workers, the risk of lung cancer and mesothelioma was increased, but considerably lower than among insulators, asbestos sprayers, or patients with asbestosis. As it was not possible to follow most of the invited nonparticipants in the original screening study, selection bias by smoking or other life-style factors possibly correlated to the individual's decision to participate in the health screening cannot be excluded.

Cancer Incidence in Asbestos-Exposed Workers: An Update on Four Finnish Cohorts

“…However, the SIR for lung cancer of nonsmokers is surprisingly low, although we have no nonsmoking population to compare it with. As detected earlier [10], the SIR for lung cancer was higher (Table 3) among those who only answered the preliminary questionnaire and did not participate in the actual study. Not participating may reflect the fact that they were not so interested in health issues and therefore, might have had an unhealthier lifestyle, which also elevates the overall risk of cancer.…”

“…There were also 5,693 workers who answered the preliminary questionnaire but did not participate in the actual screening study. Their detailed asbestos exposure remained unclear, although they had been employed in asbestos exposing industry over 10 years [10].…”

All‐cause mortality and cancer incidence among adults exposed to blue asbestos during childhood

“…Individual cancers that were significantly elevated in the males included leukemia (for both censoring dates), and prostate, brain, and colorectal cancers (for SIR2 only). All of these have previously been associated with asbestos exposure [Becker et al, 2001; Koskinen et al, 2003; Aliyu et al, 2005; Bunderson‐Schelvan et al, 2011] but definitive cause and effect relationships have not been established. There are very few existing data for an association between these cancers and non‐occupational exposure to asbestos and no data on predominant childhood exposure.…”

Estimated risk assessment of the exposed to asbestos

“…Epidemiological data is underline how important the du-ration of the interval between exposure and the detection of the clinical condition of the employee is as a risk factor. Latency time between the contact with asbestos fibers and the onset of mesothelioma is quite long (51).…”