Asbestosis and abdominal neoplasms

Our plain-English summary of Asbestosis and abdominal neoplasms, by E.E. Keal (Lancet, 1960).

The study

• Author: E.E. Keal
• Journal: Lancet
• Published: 1960;2(7162):1211-6
• Cited by: 94 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

The author reviewed The London Hospital's records since 1948 of asbestosis inpatients: 23 women and 19 men. Of 15 women known to have died, 4 had lung cancer and 9 had intra-abdominal neoplasms. Of those 9, 1 had ovarian carcinoma, 4 had peritoneal growths possibly of ovarian origin, and 4 had carcinomatosis peritonei with no primary found. Of 15 men known to have died, 10 had lung cancer and 1 was thought to have malignant mesothelioma of peritoneum, though some features suggested a primary bronchial neoplasm. The author said the men's lung cancer figure (67%) was largely explained by selection of referred patients. The 4 women with lung cancer were all nonsmokers. One woman with peritoneal cancer had asbestos bodies in her sputum thirty-three years after exposure ceased, without evidence of asbestosis. The author said the series was too small for statistical analysis. The author discussed whether the peritoneal cases were spread from missed lung cancers but judged such spread unlikely. The author concluded the peritoneal cancer finding appeared to be more than a chance association. Fiber types were not named.

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: Case series based on a search of hospital records, with detailed case histories
• Who was studied: 23 women and 19 men admitted as inpatients with a diagnosis of asbestosis at The London Hospital, London, since 1948. Outpatients with asbestosis were not included.
• Exposure: Occupational asbestos exposure. Fiber types are not named, and the occupational histories were given in tables that are not reproduced in the text. Jobs mentioned include the mattress department of an asbestos company (three years) and the slab-making department of an asbestos factory (one year).
• Main results:
  • Of the 15 women known to have died, 4 died with lung cancers and 9 with intra-abdominal neoplasms
  • Of the 15 men known to have died, 10 had lung cancer and 1 was thought to have a malignant mesothelioma of peritoneum, though there were some features suggestive of a primary bronchial neoplasm
  • 9 women and 1 man died with ovarian or peritoneal cancer. For the women, this was 9 of 15 deaths (60%).
  • Of the 30 deaths (15 men, 15 women), 14 were with lung cancer: 10 in men and 4 in women
  • Lung cancer at necropsy among the men was 67%. The author said this was largely explained by selection of patients referred with a lung cancer diagnosis.
  • Among the women, lung cancer accounted for 26% of all deaths associated with asbestosis
  • The 4 women with lung cancer were all nonsmokers
  • Only 1 woman (case 1) had a definite ovarian neoplasm without peritoneal involvement. The author stated that at least four of the tumours were not of ovarian origin.
  • The author judged that spread from undiagnosed lung cancer seemed unlikely as the source of the peritoneal cancers
  • The average period after first exposure was under twenty-five years for the 14 patients with lung cancer, compared with thirty years for the group with peritoneal cancer
  • One woman (case 8) with peritoneal cancer had asbestos bodies in her sputum thirty-three years after exposure ceased. She had no chest symptoms or definite X-ray abnormality and could not be said to have asbestosis.
• The authors' conclusion: The author concluded that the association of asbestosis with ovarian or peritoneal cancer appeared to be more than a chance association, and that spread from undiagnosed lung cancer seemed unlikely. The author also stated that no single satisfactory explanation could be drawn from the available material.
• Limitations the authors state:
  • The series was too small for statistical analysis
  • Outpatients with asbestosis were not in the diagnostic index, so their total numbers are not known
  • The peritoneal cases might be secondary cancers from undetected bronchial (lung) primaries rather than a new entity
  • In one case (case 5), the diagnosis was only clinical, without laparotomy or postmortem examination
  • The lung cancer rate among men was affected by selection of patients referred with a lung cancer diagnosis

Topics

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

Medical terms in this study, explained in our Lexicon: Neoplasm.

Related studies

• Malignant mesothelioma associated with hypoglycemia; report of a case — K.A. Nesbitt, J.T. Boswell, et al. (1958)
• Neoplasia among insulation workers in the United States with special reference to intra-abdominal neoplasia — E.C. Hammond, I.J. Selikoff, et al. (1965)
• Loss of BAP1 expression is very rare in peritoneal and gynecologic serous adenocarcinomas and can be useful in the differential diagnosis with abdominal mesothelioma — J. Andrici, J. Jung, et al. (2016)
• Genome-wide analysis of abdominal and pleural malignant mesothelioma with DNA arrays reveals both common and distinct regions of copy number alteration — A.C. Borczuk, J. Pei, et al. (2016)
• Utility of glucose transporter 1 in the distinction of benign and malignant thoracic and abdominal mesothelial lesions — S.M. Lagana, R.N. Taub, et al. (2012)
• Mesothelioma as a rapidly developing Giant Abdominal Cyst — D. Vyas, K. Pihl, et al. (2012)

Browse more research in Lancet, or return to medical research.