Asbestos and malignancy

Our plain-English summary of Asbestos and malignancy, by Z. Cope (British Medical Journal, 1964).

The study

• Author: Z. Cope
• Journal: British Medical Journal
• Published: 1964;2(5403):202
• Type of article: Historical article
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001550).

Summary of the article

This leading article reviewed the published evidence linking asbestos exposure with malignant disease. It noted that since Lynch and Smith described a case of lung cancer with asbestosis, evidence connecting the two had increased. Gloyne found bronchial carcinoma in 14% of a series of asbestosis cases. Doll calculated a lung cancer risk ten times that of the general population in workers exposed for 20 years or more. Braun and Truan, in Canada, failed to show an association. Enticknap and Smither described eleven peritoneal tumours in asbestos workers, all with histological evidence of asbestosis and at least twenty years after first exposure. Selikoff and colleagues followed 632 insulation workers for 20 years and found lung cancer seven times, and cancer of the stomach, colon and rectum three times, more often than expected, plus three pleural and one peritoneal mesothelioma. Wagner and co-workers described 47 patients with diffuse pleural mesothelioma, all but one probably exposed to crocidolite, only eight with confirmed asbestosis. The article also discussed difficulties in diagnosing diffuse mesothelial tumours, asbestos bodies in patients' lungs, fibre types, possible mechanisms and limited animal work. It concluded that until these questions were answered all exposure to asbestos dust should be considered hazardous, and that supervision should be extended to insulation workers in ships, factories and domestic buildings.

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 1964 unsigned leading article (editorial) in the British Medical Journal, attributed in the citation to Z. Cope, reviewed published reports linking asbestos with cancer. It presented no new study of its own. It recounted that Gloyne found carcinoma of the bronchus in 14% of a series of asbestosis cases. Doll calculated the lung cancer risk in workers exposed to asbestos dust for 20 years or more to be ten times that of the general population, while Braun and Truan, in Canada, failed to show an association between lung cancer and asbestosis. It described Enticknap and Smither's eleven cases of peritoneal tumours in asbestos workers, and Selikoff and colleagues' 632 insulation workers, among whom lung cancer occurred seven times more often than expected. It also described Wagner and colleagues' 47 patients with diffuse pleural mesotheliomas, all but one probably exposed to crocidolite. The article warned that diffuse pleural tumours can be secondary to bronchial carcinoma and that few of Wagner's cases were confirmed at necropsy. The author concluded that, until open questions were answered, all exposure to asbestos dust should be considered hazardous.

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: Editorial (leading article) reviewing published reports on asbestos and cancer; no original data
• Who was studied: No study population of its own; the article discussed published reports on people with asbestosis, asbestos workers (including 632 insulation workers in the building trade), patients with pleural and peritoneal tumours, and an experiment in rats
• Exposure: Asbestos dust and asbestosis; the article discussed chrysotile, crocidolite and amosite, noting that many reported tumours had been associated with crocidolite and some with chrysotile
• Main results:
  • Reported from Gloyne: 14% of a series of cases of asbestosis had carcinoma of the bronchus
  • Reported from Doll: the average risk of lung cancer in workers exposed to asbestos dust for 20 years or more was calculated to be ten times that in the general population
  • Reported from Braun and Truan in Canada: they failed to show an association between lung cancer and asbestosis
  • Reported from Enticknap and Smither: eleven cases of peritoneal tumours in asbestos workers, all with histological evidence of asbestosis
  • Reported from Selikoff and colleagues: among 632 insulation workers followed for 20 years, lung cancer occurred seven times more frequently than expected, and three pleural mesotheliomas and one peritoneal mesothelioma were found
  • Reported from Wagner and co-workers: 47 patients with diffuse pleural mesotheliomas, all but one probably exposed to crocidolite; only eight had confirmed asbestosis
  • Reported from Hourihane's review of London Hospital necropsy files from 1917 to 1962: 17 of 38 pleural tumours and 17 of 55 peritoneal tumours were accepted as mesotheliomata
  • Reported from McCaughey and colleagues: asbestos bodies were found in the lung in 12 of 15 patients with mesothelioma of the pleura
  • Reported from Wagner's experiment: three mesotheliomata in 50 rats injected intrapleurally with asbestos, and one similar tumour in a group of ten injected with silica
  • The article stated that there appeared to be no correlation between the severity of asbestosis and the occurrence of pleural or peritoneal tumours, and that in some cases exposure seemed slight
• The authors' conclusion: The author concluded that until the questions raised by recent findings are answered, all exposure to asbestos dust should be considered hazardous, and supervision should be extended to insulation workers in ships, factories and domestic buildings
• Limitations the authors state:
  • Diagnosis of diffuse tumours was uncertain: only four of 33 cases described as pleural mesothelioma by Wagner and colleagues were confirmed at necropsy
  • The significance of finding asbestos bodies was hard to assess because their frequency in lungs without mesothelioma was unknown
  • Little experimental work on the carcinogenic effects of asbestos had been published

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Lung Cancer, Carcinoma, Insulator, Stomach Cancer, Peritoneal Mesothelioma, Pleural Mesothelioma, Crocidolite.

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