Are lung and pleural benign asbestos induced diseases a preliminary step in the pathogenic process of mesothelioma and lung cancer development?

Our plain-English summary of Are lung and pleural benign asbestos induced diseases a preliminary step in the pathogenic process of mesothelioma and lung cancer development?, by M. Goldberg (Occupational and Environmental Medicine, 2005).

The study

• Author: M. Goldberg
• Journal: Occupational and Environmental Medicine
• Published: 2005;62(10):663-4
• Type of article: Comment
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

In this commentary, the author discussed whether benign asbestos-related lung and pleural diseases (pleural plaques, pleural calcification and thickening, and asbestosis) are a preliminary step towards malignant mesothelioma and lung cancer, or whether their association with these cancers only reflects a common cause, asbestos exposure. He described three hypotheses tested in epidemiological studies: a single sequential pathogenic process, a common cause without interaction, and a common cause with interaction. He reported that animal data gave some support to fibrosis preceding cancer but had limitations, and that cohort and case-control studies had given inconsistent results. He then discussed the study by Reid et al, published in the same issue, of former workers and residents of Wittenoom exposed to crocidolite. That study found that, for the same level of asbestos exposure, the risk of pleural mesothelioma did not differ between subjects with and without radiological signs of lung and pleural fibrosis, whereas the risk of peritoneal mesothelioma was higher in those with such signs. He considered this to favour the common cause without interaction hypothesis for pleural mesothelioma, and to give some strength to the common cause with interaction hypothesis for peritoneal mesothelioma. He noted open questions: exposure was to crocidolite only, the higher exposures may have been underestimated, and benign chest diseases may have been underestimated. He concluded that the mechanisms remain open. He said this matters because some countries compensate asbestos-induced cancers only in patients with chest abnormalities.

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 article was a two-page commentary by M Goldberg on a separate study by Reid et al, published in the same journal issue. It reported no new data of its own. The author asked whether benign asbestos diseases (pleural plaques, pleural thickening and asbestosis) are a step on the way to mesothelioma and lung cancer, or whether they simply share asbestos as a common cause. The author described earlier animal and human studies as giving limited or inconsistent answers. According to the commentary, Reid et al studied a cohort exposed to crocidolite. They found that, at the same level of asbestos exposure, the risk of pleural mesothelioma did not differ between people with and without radiological signs of lung and pleural fibrosis. The risk of peritoneal mesothelioma was higher for those with such signs. The author raised three concerns: only crocidolite was studied, higher exposures may have been underestimated, and benign chest disease may also have been underestimated. The author concluded that the mechanisms of asbestos-induced cancers remain an open question. The author also noted that some countries compensate these cancers only when chest abnormalities are present.

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: Commentary on another study (Reid et al), with a brief discussion of earlier research; no original data
• Who was studied: No study population of its own. The commentary discusses the cohort in Reid et al, described in the reference list as former workers and residents of Wittenoom
• Exposure: Crocidolite asbestos, the exposure of the cohort in Reid et al
• Main results:
  • As described by the commentary, Reid et al found that at the same level of asbestos exposure, the risk of pleural mesothelioma did not differ between subjects with and without radiological signs of lung and pleural fibrosis
  • As described by the commentary, Reid et al found that the risk of peritoneal mesothelioma was higher for subjects showing radiological signs
  • The author interpreted the peritoneal findings as giving some support to the 'common cause with interaction' hypothesis
  • The author stated that earlier cohort studies of asbestos workers on plaques or asbestosis and lung cancer risk were not consistent
• The authors' conclusion: The author concluded that the question of the mechanisms of asbestos-induced cancers remains open
• Limitations the authors state:
  • The author noted that Reid et al's cohort was exposed to crocidolite, and that other asbestos types, especially less biopersistent forms, may act differently
  • The author noted that in Reid et al the higher exposures may have been underestimated
  • The author noted that benign chest diseases may also have been underestimated in Reid et al

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer, Mesothelioma, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Cancer, Pleural Plaques, Pleural Calcification, Malignant Mesothelioma, Asbestos Exposure, Fibrosis, Wittenoom.

Related studies

• New developments in asbestos-induced pleural disease — D.A. Schwartz (1991)
• Preliminary study of positron emission tomography/computed tomography and plasma osteopontin levels in patients with asbestos-related pleural disease — S. Kurata, M. Ishibashi, et al. (2010)
• Clinical value of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiation of malignant mesothelioma from asbestos-related benign pleural disease: an observational pilot study — H. Yildirim, M. Metintas, et al. (2009)
• Asbestos-related benign pleural disease — C. Peacock, S.J. Copley, et al. (2000)
• Benign asbestos pleural diseases — S.J. Chapman, W.O. Cookson, et al. (2003)
• The additional risk of malignant mesothelioma in former workers and residents of Wittenoom with benign pleural disease or asbestosis — A. Reid, N. de Klerk, et al. (2005)

Browse more research in Occupational and Environmental Medicine, or return to medical research.