Background <p>The aim of this study was to analyse the incidence and mortality from various digestive cancer sites and their potential link with pleural plaques, in a French cohort of workers previously occupationally exposed to asbestos.</p> Methods <p>We conducted a 10-year follow-up study in 13,481 male subjects, included in the cohort between October 2003 and December 2005, for whom asbestos exposure was assessed by calculation of a cumulative exposure index (CEI) in equivalent fibres.years/mL for each subject. We conducted an incidence study and a mortality study. Complementary analysis was restricted to men who had performed at least one chest CT-scan (<i>N</i> = 4,794). We used a Cox model with age as the time axis variable, adjusted for smoking, time since first exposure (TSFE), CEI to asbestos and the existence of pleural plaques on CT-scan.</p> Results <p>In the incidence study, a significant dose–response relationship was observed between CEI to asbestos and oesophageal cancer (HR 1.03, 95% CI [1.01–1.06]) in the entire cohort after adjustment for TSFE and smoking status. In subjects undergoing CT-scan, a significant association between pleural plaques was observed for oesophageal cancer incidence (HR 2.80, 95% CI [1.09–7.20]) and in the mortality study, multivariate analyses showed a significant dose–effect response between CEI to asbestos and death from oesophageal cancer (HR 1.03, 95% CI [1.00–1.05]) in the entire cohort<i>.</i></p> Conclusions <p>This large-scale study confirms results concerning a likely relationship between asbestos exposure and oesophageal cancer, and the association between this cancer and pleural plaques after adjustment on CEI to asbestos.</p>

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Asbestos exposure, pleural plaques and digestive cancers

  • Bénédicte Clin,
  • Céline Gramond,
  • Fleur Delva,
  • Pascal Andujar,
  • Isabelle Thaon,
  • Patrick Brochard,
  • Julia Benoist,
  • Antoine Gislard,
  • François Laurent,
  • Ilyes Benlala,
  • Christophe Paris,
  • Jean-Claude Pairon

摘要

Background

The aim of this study was to analyse the incidence and mortality from various digestive cancer sites and their potential link with pleural plaques, in a French cohort of workers previously occupationally exposed to asbestos.

Methods

We conducted a 10-year follow-up study in 13,481 male subjects, included in the cohort between October 2003 and December 2005, for whom asbestos exposure was assessed by calculation of a cumulative exposure index (CEI) in equivalent fibres.years/mL for each subject. We conducted an incidence study and a mortality study. Complementary analysis was restricted to men who had performed at least one chest CT-scan (N = 4,794). We used a Cox model with age as the time axis variable, adjusted for smoking, time since first exposure (TSFE), CEI to asbestos and the existence of pleural plaques on CT-scan.

Results

In the incidence study, a significant dose–response relationship was observed between CEI to asbestos and oesophageal cancer (HR 1.03, 95% CI [1.01–1.06]) in the entire cohort after adjustment for TSFE and smoking status. In subjects undergoing CT-scan, a significant association between pleural plaques was observed for oesophageal cancer incidence (HR 2.80, 95% CI [1.09–7.20]) and in the mortality study, multivariate analyses showed a significant dose–effect response between CEI to asbestos and death from oesophageal cancer (HR 1.03, 95% CI [1.00–1.05]) in the entire cohort.

Conclusions

This large-scale study confirms results concerning a likely relationship between asbestos exposure and oesophageal cancer, and the association between this cancer and pleural plaques after adjustment on CEI to asbestos.