Cigarette smoking, asbestos exposure, lung cancer, and sample size

Our plain-English summary of Cigarette smoking, asbestos exposure, lung cancer, and sample size, by M.F. Petrini (American Journal of Respiratory and Critical Care Medicine, 1998).

The study

• Author: M.F. Petrini
• Journal: American Journal of Respiratory and Critical Care Medicine
• Published: 1998;158(5 Pt 1):1688
• Type of article: Comment, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item is not a research study. It is a published letter to the editor by Petrini, with a reply from Lee and Christiani, about an earlier article by Lee and colleagues on cigarette smoking, asbestos exposure, and the location and histology of lung cancer. The letter quoted that article as reporting that 9.5% of patients with adenocarcinomas reported asbestos exposure, compared with 15.3% of those with other lung cancer types. That difference was not statistically significant (OR = 1.72; 95% CI: 0.95 to 3.12, p = 0.09). The letter writer argued that a difference that is not statistically significant cannot be treated as a difference. The writer suggested the result might reflect too few patients with asbestosis who presented with tumors, but noted this was hard to judge without the raw data. In reply, Lee and Christiani said they could not rule out lack of statistical power, but did not consider it the most likely explanation. They concluded that the trend toward fewer adenocarcinomas with asbestos exposure (46.9% versus 60.3%) was more likely due to multiple comparisons.

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: Letter to the editor (correspondence) commenting on an earlier article, with a reply from that article's authors; no new data
• Who was studied: No population studied in this item; it discusses the lung cancer patients in the earlier study by Lee and colleagues
• Exposure: Asbestos exposure (fiber types not specified) and cigarette smoking, as discussed in the earlier article
• Main results:
  • The letter quoted the earlier article: 9.5% of patients with adenocarcinomas reported asbestos exposure, versus 15.3% of patients with other types of lung cancer (p = 0.09, not statistically significant)
  • The letter quoted the earlier article's odds ratio for this comparison: OR = 1.72; 95% CI: 0.95 to 3.12, p = 0.09
  • Adenocarcinomas made up 46.9% of tumors among those exposed to asbestos versus 60.3% among those not exposed (p = 0.09), as cited from the earlier study
  • The letter writer argued that a difference that is not statistically significant should not be treated as a difference
  • The letter writer suspected insufficient sample size, namely the small number of patients with asbestosis who presented with tumors
  • The original authors replied that lack of power was not, in their view, the most likely explanation
  • The original authors said their results agreed with most prior studies reporting no specific association between asbestos exposure and adenocarcinoma
• The authors' conclusion: The letter writer believed this uncertainty, properly stated, did not detract from the study's other conclusions. The original authors concluded that the near-significant negative association between adenocarcinoma and asbestos exposure was more likely due to multiple comparisons.
• Limitations the authors state:
  • The letter writer said it was difficult to tell which explanation applied without access to the raw data
  • The original authors acknowledged they could not exclude lack of power as an explanation

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: Asbestos Exposure, Lung Cancer.

Related studies

• Association of cigarette smoking and asbestos exposure with location and histology of lung cancer — B.W. Lee, J.C. Wain, et al. (1998)
• Cigarette smoking associated with lung adenocarcinoma in situ in a large case-control study (SFBALCS) — P.M. Bracci, J. Sison, et al. (2012)
• Interaction of asbestos, age, and cigarette smoking in producing radiographic evidence of diffuse pulmonary fibrosis — K.H. Kilburn, R. Lilis, et al. (1986)
• Cigarette smoking, asbestos, and pulmonary fibrosis — W. Weiss (1971)
• Absence of synergism between exposure to asbestos and cigarette smoking in asbestosis — J.M. Samet, G.R. Epler, et al. (1979)
• Types, numbers, sizes, and distribution of mineral particles in the lungs of urban male cigarette smokers — A. Churg, B. Wiggs (1987)

Browse more research in American Journal of Respiratory and Critical Care Medicine, or return to medical research.