A critique of a review on the relationship between asbestos exposure and the risk of mesothelioma: reply

Our plain-English summary of A critique of a review on the relationship between asbestos exposure and the risk of mesothelioma: reply, by C. La Vecchia, P. Boffetta (European Journal of Cancer Prevention, 2014).

The study

• Authors: C. La Vecchia, P. Boffetta
• Journal: European Journal of Cancer Prevention
• Published: 2014;23(5):494-6
• Type of article: Letter, Comment
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, La Vecchia and Boffetta replied to Terracini and colleagues' critique of their 2012 review on how stopping exposure, and recent exposure, to asbestos affects mesothelioma risk. They stated that the review addressed cessation of exposure, not duration of exposure. They noted that the critics had not named any omitted study reporting results by time since cessation. For the Italian asbestos cement cohort (Magnani et al., 2008), they said their reading matched the original authors' report of a non-significant trend toward reduced risk more than 15 years after cessation. They described the Italian asbestos textile cohort (Pira et al.) as informative because 54% of workers were women and 33 of 68 mesothelioma deaths occurred in workers employed less than 5 years. They combined pleural and peritoneal cases there because the SMRs were similar (46 and 37). They said the UK case-control results by duration were not adjusted for latency. For the Great Britain Asbestos Survey, they called left-censoring a common limitation. They reported a relative risk of 0.99 both at 30 or more years since last exposure (one death) and at 20-30 years (89 deaths). They agreed that pleural and peritoneal mesothelioma should be distinguished. They concluded that their review adequately summarized the limited data. Both authors declared serving as expert witnesses for defendants, and one also for a judge, in asbestos-related criminal trials.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This is a letter to the editor in which the authors replied to Terracini and colleagues' critique of their 2012 review on whether stopping asbestos exposure changes later mesothelioma risk. It reported no new data. The authors stated that their review was about cessation, not duration, of exposure, and that the critics had named no study reporting results by cessation that should have been included. They defended their reading of earlier studies. For a cohort of Italian asbestos textile workers, they noted that 33 of 68 mesothelioma deaths were in workers employed less than 5 years. For the Great Britain Asbestos Survey, they wrote that only one mesothelioma death was observed 30 or more years after last exposure, with a relative risk of 0.99. That was the same as for 20 to 30 years since last exposure (relative risk 0.99, based on 89 deaths). They agreed that pleural and peritoneal mesothelioma should be distinguished. The authors concluded that their review adequately summarized the rather limited available data. Both authors disclosed acting as expert witnesses for defendants in asbestos-related criminal trials, and one also acted for the judge.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor: the authors' reply to a critique of their 2012 review; no new data
• Who was studied: No new study population. The letter discusses studies covered by the authors' review: Italian asbestos cement workers (Magnani et al., 2008), Italian asbestos textile workers (Pira et al., 2005; 2007), a UK case-control study (Rake et al., 2009), and the Great Britain Asbestos Survey (Harding and Darnton, 2010).
• Exposure: Occupational asbestos exposure, specifically time since cessation of exposure (not duration of exposure); fiber types not specified
• Main results:
  • The authors stated that the critics did not identify any other study reporting results by cessation of exposure that the review should have included.
  • For the Italian asbestos cement worker study (Magnani et al., 2008), the authors said their reading of no clear effect of time since cessation matched that study's own authors.
  • In the Italian asbestos textile worker cohort (Pira et al.), 33 of 68 mesothelioma deaths were among workers employed for less than 5 years.
  • In the same textile cohort, the authors justified combining pleural and peritoneal mesothelioma because the SMRs were similar: 37 for peritoneal and 46 for pleural.
  • For the UK case-control study (Rake et al., 2009), the authors said the results by duration were not easily interpretable because that analysis was not adjusted for latency.
  • In the Great Britain Asbestos Survey, only one mesothelioma death was observed 30 or more years after last exposure, with a relative risk of 0.99, the same as for the 20 to 30 year category (relative risk 0.99, based on 89 deaths).
  • The authors stated that left-censoring (exclusion of workers who left employment before the cohort was assembled) is common in occupational epidemiology and not unique to the Great Britain Asbestos Survey.
  • The authors agreed that pleural and peritoneal mesothelioma should be distinguished.
• The authors' conclusion: The authors concluded that their review adequately summarized the rather limited data available on mesothelioma risk according to time since cessation of exposure.
• Limitations the authors state:
  • The available data on mesothelioma risk by time since cessation of exposure are rather limited.
  • A larger dataset would be needed to analyze pleural and peritoneal mesothelioma separately in the textile cohort.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Mesothelioma, Asbestos-Cement, Latency, Relative Risk, Peritoneal Mesothelioma, Expert Witness, Defendant.

Related studies

• A critique to a review on the relationship between asbestos exposure and the risk of mesothelioma — B. Terracini, D. Mirabelli, et al. (2014)
• Reply: comment on 'estimating the asbestos-related lung cancer burden from mesothelioma mortality' — V. McCormack, J. Peto, et al. (2013)
• Role of stopping exposure and recent exposure to asbestos in the risk of mesothelioma — C. La Vecchia, P. Boffetta (2012)
• A review and critique of U.S. EPA's risk assessments for asbestos — S.H. Moolgavkar, E.L. Anderson, et al. (2014)
• Environmental exposure to crocidolite and mesothelioma: exposure-response relationships — J. Hansen, N.H. de Klerk, et al. (1998)
• Cancer incidence within a cohort occupationally exposed to asbestos: a study of dose--response relationships — B. Clin, F. Morlais, et al. (2011)

Browse more research in European Journal of Cancer Prevention, or return to medical research.