Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies

ObjectivesModels based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off m...

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Published inOccupational and environmental medicine (London, England) Vol. 76; no. 9; pp. 611 - 616
Main Authors Barone-Adesi, Francesco, Ferrante, Daniela, Chellini, Elisabetta, Merler, Enzo, Pavone, Venere, Silvestri, Stefano, Miligi, Lucia, Gorini, Giuseppe, Bressan, Vittoria, Girardi, Paolo, Ancona, Laura, Romeo, Elisa, Luberto, Ferdinando, Sala, Orietta, Scarnato, Corrado, Menegozzo, Simona, Oddone, Enrico, Tunesi, Sara, Perticaroli, Patrizia, Pettinari, Aldo, Cuccaro, Francesco, Curti, Stefania, Baldassarre, Antonio, Cena, Tiziana, Angelini, Alessia, Marinaccio, Alessandro, Mirabelli, Dario, Musti, Marina, Pirastu, Roberta, Ranucci, Alessandra, Magnani, Corrado, Ballarin, Maria Nicoletta, Bisceglia, Lucia, Brentisci, Carol, Cortini, Barbara, Mattioli, Stefano, Gangemi, Manuela, Gioffrè, Francesco, Legittimo, Patrizia, Mangone, Lucia, Marinelli, Francesco, Marinilli, Pasqualina, Nannavecchia, Anna Maria, Panato, Chiara, Roncaglia, Francesca, Storchi, Cinzia, Stura, Antonella, Vicentini, Massimo, Verdi, Simona
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group Ltd 01.09.2019
BMJ
BMJ Publishing Group LTD
Subjects
Adolescent
Adult
Asbestos
Asbestos - adverse effects
Cancer
Cohort analysis
Epidemiology
Exposure
Female
Fibers
Gastric cancer
Humans
Hypotheses
Italy - epidemiology
Lungs
Male
Mathematical models
Mesothelioma
Middle Aged
Models, Theoretical
Mortality
Multistage
Occupational Diseases - mortality
Occupational Exposure - adverse effects
ORIGINAL ARTICLE
Peritoneal cancer
Peritoneal Neoplasms - mortality
Peritoneum
Pleural Neoplasms - mortality
Studies
Time Factors
Trends
Workplace
Young Adult
Italy
Australia
asbestos
mesothelioma
epidemiology
Online AccessGet full text
ISSN1351-0711
1470-7926
1470-7926
DOI10.1136/oemed-2019-105779

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Abstract ObjectivesModels based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis.MethodsWe used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time.ResultsRates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer.ConclusionsRates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations.
AbstractList Models based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis.OBJECTIVESModels based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis.We used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time.METHODSWe used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time.Rates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer.RESULTSRates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer.Rates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations.CONCLUSIONSRates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations.
ObjectivesModels based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis.MethodsWe used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time.ResultsRates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer.ConclusionsRates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations.
Models based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis. We used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time. Rates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer. Rates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations.
Author Merler, Enzo
Cena, Tiziana
Luberto, Ferdinando
Perticaroli, Patrizia
Baldassarre, Antonio
Tunesi, Sara
Pettinari, Aldo
Chellini, Elisabetta
Ferrante, Daniela
Miligi, Lucia
Barone-Adesi, Francesco
Silvestri, Stefano
Gorini, Giuseppe
Menegozzo, Simona
Mirabelli, Dario
Ranucci, Alessandra
Pavone, Venere
Magnani, Corrado
Sala, Orietta
Curti, Stefania
Romeo, Elisa
Bressan, Vittoria
Ancona, Laura
Musti, Marina
Cuccaro, Francesco
Oddone, Enrico
Marinaccio, Alessandro
Scarnato, Corrado
Girardi, Paolo
Angelini, Alessia
Pirastu, Roberta
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/31413184$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Contributor Bisceglia, Lucia
Panato, Chiara
Gioffrè, Francesco
Cortini, Barbara
Nannavecchia, Anna Maria
Ballarin, Maria Nicoletta
Legittimo, Patrizia
Storchi, Cinzia
Verdi, Simona
Marinilli, Pasqualina
Mattioli, Stefano
Marinelli, Francesco
Brentisci, Carol
Vicentini, Massimo
Gangemi, Manuela
Mangone, Lucia
Roncaglia, Francesca
Stura, Antonella
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Copyright Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Author(s) (or their employer(s)) 2019
2019 Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Copyright_xml – notice: Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
– notice: Author(s) (or their employer(s)) 2019
– notice: 2019 Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
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Keywords asbestos
mesothelioma
epidemiology
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Snippet ObjectivesModels based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure...
Models based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to...
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StartPage 611
SubjectTerms Adolescent
Adult
Asbestos
Asbestos - adverse effects
Cancer
Cohort analysis
Epidemiology
Exposure
Female
Fibers
Gastric cancer
Humans
Hypotheses
Italy - epidemiology
Lungs
Male
Mathematical models
Mesothelioma
Middle Aged
Models, Theoretical
Mortality
Multistage
Occupational Diseases - mortality
Occupational Exposure - adverse effects
ORIGINAL ARTICLE
Peritoneal cancer
Peritoneal Neoplasms - mortality
Peritoneum
Pleural Neoplasms - mortality
Studies
Time Factors
Trends
Workplace
Young Adult
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Title Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies
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