Asbestos, smoking, and lung cancer: interaction and attribution

Our plain-English summary of Asbestos, smoking, and lung cancer: interaction and attribution, by B.W. Case (Occupational and Environmental Medicine, 2006).

The study

• Author: B.W. Case
• Journal: Occupational and Environmental Medicine
• Published: 2006;63(8):507-8
• Type of article: Comment
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Commentary on the paper by Reid et al (see page 509)

In plain English

This is a short commentary by the author on a separate paper by Reid et al. in the same journal issue. It reports no new data. The author discussed why lung cancer is harder to attribute to asbestos than mesothelioma, because smoking causes most lung cancers. The author cited a rule of thumb of two asbestos-related lung cancers for every mesothelioma, and up to 10 to 1 in some heavily exposed groups. The author said the old idea that asbestosis had to be present before lung cancer could be blamed on asbestos was mistaken. The author described Reid et al.'s work on crocidolite miners and millers at Wittenoom, Australia, as showing that the combined effect of smoking and asbestos was less than multiplying the two risks but more than adding them. The author said the lowest asbestos dose that can cause lung cancer remains controversial. The author concluded that a practical case-by-case approach, backed by common-sense rules about length and type of employment, seemed best.

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 (no original data) on a separate paper by Reid et al.
• Who was studied: No population was studied. The commentary discusses the Reid et al. paper on crocidolite miners and millers at Wittenoom and refers to the Quebec chrysotile miners and millers cohort.
• Exposure: Asbestos exposure (chrysotile in Quebec, crocidolite at Wittenoom) combined with cigarette smoking
• Main results:
  • The author described Reid et al.'s finding: the interaction between smoking and asbestos was less than multiplicative but more than additive.
  • The author cited a rule of thumb of two asbestos-related lung cancers for every mesothelioma, with a ratio of up to 10:1 in some heavily exposed occupational cohorts.
  • The author cited an estimate that, in the United Kingdom, asbestos-related lung cancer is 2–3% of all lung cancer.
  • The author wrote that the idea that clinical asbestosis was a necessary precondition for asbestos-related lung cancer was mistaken.
  • The author wrote that the lowest dose at which asbestos even partly causes lung cancer remains controversial.
• The authors' conclusion: The author concluded that a practical, case-by-case approach, supplemented by common-sense rules about, for example, length and type of employment, seemed best, and that better knowledge of the smoking interaction would help.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Attribution.

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• Asbestos and lung cancer: an analysis of the epidemiological evidence on the asbestos-smoking interaction — R. Saracci (1977)
• The interactions of tobacco smoking and other agents in cancer etiology — R. Saracci (1987)
• Interaction of asbestos, age, and cigarette smoking in producing radiographic evidence of diffuse pulmonary fibrosis — K.H. Kilburn, R. Lilis, et al. (1986)
• The interaction of asbestos and smoking in lung cancer: a modified measure of effect — G. Berry, F.D. Liddell (2004)

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