Cancer due to asbestos exposure

Our plain-English summary of Cancer due to asbestos exposure, by T. Kishimoto (Chest, 1992).

The study

• Author: T. Kishimoto
• Journal: Chest
• Published: 1992;101(1):58-63
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004135).

Abstract

To determine the relationship between malignancies and asbestos exposure, the number of asbestos bodies in wet lung tissue was counted by light microscopy according to the modified method of Smith and Naylor, and occupational histories were examined. The results revealed that 17 (89 percent) of 19 malignant mesotheliomas, 39 (38 percent) of 104 lung cancers, 23 (37 percent) of 62 gastric cancers, and 13 (28 percent) of 45 colon cancers were shown to be cases with asbestos exposure. These values were significantly higher than those of noncancerous cases (200 cases). It is of interest that five out of ten cases of leukemia were related to asbestos exposure. Nearly all multiple cancers including lung and gastric cancer in this study were also cases with asbestos exposure. Additional research should be conducted on the carcinogenicity of asbestos for multiple cancers.

In plain English

This autopsy study covered 533 patients from the Kure area of Japan, autopsied at Kure Kyosai Hospital from 1984 to 1989. The author counted asbestos bodies in lung tissue, identified fiber types, reviewed work histories, and compared cancer cases with 200 noncancerous cases. There were 19 malignant mesotheliomas: 16 pleural, 2 peritoneal and 1 pericardial. Fourteen of these patients had shipyard work indicating asbestos exposure, and crocidolite was the main fiber in 8 of 11 mesotheliomas. For lung and gastric cancer, the marker was 500 or more asbestos bodies per 5 g of lung. By that measure, 39 of 104 lung cancers (38 percent) were possible asbestos-related cases, and 23 of 62 gastric cancers (37 percent) reached that level. The author also reported 13 of 45 colon cancers (28 percent) as asbestos-exposed, without showing data. Each was reported as significantly higher than noncancerous cases. Fibers in lung cancers were almost all chrysotile, and almost all lung cancer patients were heavy smokers. Five of ten leukemia cases had asbestos exposure histories. The author called for more research on asbestos and multiple cancers and called the leukemia relationship unclear.

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: Hospital autopsy study comparing asbestos body counts in lung tissue, asbestos fiber types and occupational histories between cancer cases and noncancerous cases
• Who was studied: 533 patients autopsied at Kure Kyosai Hospital, 1984 to 1989, who had lived in the city or suburbs of Kure, Japan: 104 lung cancers, 19 malignant mesotheliomas, 62 gastric cancers, 45 colon cancers, 10 leukemias, 93 other malignancies and 200 noncancerous cases
• Exposure: Asbestos bodies per 5 g of wet lung tissue, counted by light microscopy. Asbestos fiber types (crocidolite, amosite, chrysotile, tremolite) were identified by scanning electron microscopy. Occupational histories were reviewed, mostly shipyard work including at a Japanese naval shipyard. For lung and gastric cancer, 500 or more asbestos bodies per 5 g of lung was the marker used.
• Main results:
  • Malignant mesothelioma (19 cases: 16 pleural, 2 peritoneal, 1 pericardial; 17 men, 2 women): 13 men and 1 woman had shipyard work indicating asbestos exposure. Four cases (3 men, 1 woman) showed no clear relationship to asbestos exposure.
  • Mesothelioma cases: crocidolite was the main fiber type in 8 of 11 cases and amosite in four. Average latency was 40 years and average duration of exposure was 24 years.
  • Lung cancer: 39 of 104 cases (38 percent) were considered possible asbestos-related lung cancers because they had 500 or more asbestos bodies per 5 g of lung. This was 37 (40 percent) of the 92 men and 2 (17 percent) of the 12 women.
  • Asbestos body counts in mesothelioma, lung cancer and gastric cancer cases were significantly higher (p less than 0.01) than in noncancerous cases.
  • Lung cancer cases: almost all patients were heavy smokers (Brinkman index more than 600).
  • Lung cancer cases: almost all asbestos fibers detected were chrysotile.
  • Gastric cancer: 23 of 62 cases (37 percent) had 500 or more asbestos bodies per 5 g of lung, and all 23 were men.
  • Gastric cancer cases: asbestos bodies and fibers were not found in the gastric cancer tissue itself.
  • Colon cancer: 13 of 45 cases (28 percent) were cases of asbestos exposure, significantly higher (p less than 0.05) than noncancerous cases. The data were not shown.
  • Leukemia: 5 of 10 autopsied acute leukemia cases had histories of asbestos exposure. The other five were students or housekeepers with no history of exposure.
  • Ten patients had both lung and gastric cancer (all men, aged 67 to 76, all heavy smokers). Their lungs held 103 to 82,617 asbestos bodies; the occupational history of three of them was not clear.
  • Multiple cancers: in 24 cases that included lung or gastric cancer, the mean asbestos body count was 11,373 plus or minus 6,342. This was significantly higher (p less than 0.05) than in 16 multiple-cancer cases with neither lung nor gastric cancer. The 200 nonmalignant cases had a mean of 1,059 plus or minus 327.
• The authors' conclusion: The author concluded that nearly all multiple cancers including lung and gastric cancer were cases with asbestos exposure, and that further research on the carcinogenicity of asbestos for multiple cancers is needed.
• Limitations the authors state:
  • The author stated that the relationship between leukemia and asbestos carcinogenicity is still unclear.
  • The author stated that there is no clinical evidence that asbestos induces gastrointestinal tract cancers, and that this relationship should be studied.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Asbestos Bodies, Malignant Mesothelioma, Lung Cancer, Stomach Cancer, Colorectal Cancer.

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