Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies
| Autor: | Barone-Adesi F., Ferrante D., Chellini E., Merler E., Pavone V., Silvestri S., Miligi L., Gorini G., Bressan V., Girardi P., Ancona L., Romeo E., Luberto F., Sala O., Scarnato C., Menegozzo S., Oddone E., Tunesi S., Perticaroli P., Pettinari A., Cuccaro F., Curti S., Baldassarre A., Cena T., Angelini A., Marinaccio A., Mirabelli D., Musti M., Pirastu R., Ranucci A., Magnani C., Working Group, Mattioli S. |
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| Přispěvatelé: | Barone-Adesi F., Ferrante D., Chellini E., Merler E., Pavone V., Silvestri S., Miligi L., Gorini G., Bressan V., Girardi P., Ancona L., Romeo E., Luberto F., Sala O., Scarnato C., Menegozzo S., Oddone E., Tunesi S., Perticaroli P., Pettinari A., Cuccaro F., Curti S., Baldassarre A., Cena T., Angelini A., Marinaccio A., Mirabelli D., Musti M., Pirastu R., Ranucci A., Magnani C., Working Group, Mattioli S. |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Time Factors Time Factor Adolescent Pleural Neoplasms asbestos epidemiology mesothelioma Asbesto medicine.disease_cause Asbestos Settore MED/01 - Statistica Medica NO 03 medical and health sciences Peritoneal Neoplasm Young Adult 0302 clinical medicine Internal medicine Occupational Exposure Epidemiology medicine Humans Pleural Neoplasm Mesothelioma Young adult Peritoneal Neoplasms business.industry Public Health Environmental and Occupational Health Cancer asbestos epidemiology mesothelioma Adolescent Adult Italy Middle Aged Models Theoretical medicine.disease 030210 environmental & occupational health Occupational Disease Occupational Diseases asbestos epidemiology mesothelioma Italy 030220 oncology & carcinogenesis Female business Human Cohort study |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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