Clinical study of asbestos-related lung cancer diagnosed by asbestos medical examination

Our plain-English summary of Clinical study of asbestos-related lung cancer diagnosed by asbestos medical examination, by T. Yotsumoto, A. Sano, T. Fukuda (Cancer Reports, 2018).

The study

• Authors: T. Yotsumoto, A. Sano, T. Fukuda
• Journal: Cancer Reports
• Published: 2018;1(3):e1124
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Aim: People with occupational exposure to asbestos demonstrate a high incidence of lung cancer. Asbestos medical examination for those at risk was implemented as a national policy in Japan. This study aimed to characterize patients with asbestos-related lung cancer who were diagnosed by these examinations.

Methods: We retrospectively investigated 120 individuals exposed to asbestos who were examined from 2008 to 2016 at our institution. Clinical data, including CT findings and time-related exposure variables, were evaluated. Each asbestos-related change was assigned 1 point if present, and the scores were compared between patients with and without asbestos-related lung cancer using the Mann-Whitney U test and Fisher's exact test.

Results: Five patients were diagnosed with lung cancer, and four underwent surgical treatment. At the time of writing, three of four operated patients were alive without recurrence, with a similar prognosis to patients with lung cancer unrelated to asbestos. Average scores for asbestos-related findings on CT Scan were 1.8 (9/5) for patients with lung cancer and 0.79 (91/115) for those without lung cancer.

Conclusion: Patients with lung cancer had significantly more asbestos-related changes on CT scan than those without lung cancer. Concurrent calcified plaque and interstitial changes might be a predictor of lung cancer incidence. Although further investigation with a larger study group is needed, regular medical examination and CT scan every 6 months might contribute to the early detection of lung cancer with asbestos-related changes on CT.

© 2018 Wiley Periodicals, Inc.

In plain English

This retrospective study from a hospital in Chigasaki, Japan reviewed 120 people (119 men, 1 woman) with occupational asbestos exposure who had regular asbestos medical examinations, including CT scans, from 2008 to 2016. The types and amounts of asbestos were unknown. Any lung cancer found was counted as asbestos-related because all subjects had occupational exposure and asbestos-related chest X-ray changes. Five people were diagnosed with lung cancer, an incidence rate of 71 cases per 10 000 person-years. Of four surgical patients, three were alive without recurrence when the article was written. Smoking and time-related exposure measures did not differ significantly between those with and without lung cancer. On a score counting asbestos-related CT findings, the lung cancer group averaged 1.8 and the others 0.79 (P = 0.0091). Both calcified plaque and fibrotic lung changes were found in 3 of 5 people with lung cancer and 9 people without it (out of 114 by the text, 115 by the table). The authors concluded this combination might be a predictor of lung cancer, and noted small numbers and a retrospective design as limitations.

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: Retrospective study of a cohort attending asbestos medical examinations, comparing people who were diagnosed with lung cancer with those who were not
• Who was studied: 120 individuals (119 men, 1 woman) with certified occupational asbestos exposure, examined at Chigasaki Municipal Hospital, Japan, from January 2008 to June 2016
• Exposure: Occupational asbestos exposure. Among 103 people with known job histories, 41 worked in construction; others worked in asbestos processing, shipyards, asbestos product making and other jobs. Fiber types and amounts were not known.
• Main results:
  • Lung cancer found by the examinations was defined as asbestos-related because all subjects had occupational exposure and asbestos-related chest radiograph abnormalities
  • Five subjects were diagnosed with lung cancer by the regular check-ups
  • Incidence rate of lung cancer detected by the examinations: 71 cases per 10 000 person-years
  • Three of the four patients who had surgery were alive without recurrence at the time of writing. The reported 1-year postoperative survival rate was 50%.
  • Smoking habits and time-related exposure variables did not differ significantly between the lung cancer patients and those without lung cancer
  • Average CT score for asbestos-related findings: 1.8 (9/5) in the lung cancer group versus 0.79 (91/115) in the group without lung cancer. The difference was reported as P = 0.0091.
  • Both asbestosis (fibrotic changes) and calcified plaque: 3 of 5 (60%) in the lung cancer group versus 9 people in the group without lung cancer. The text gives this as 9 of 114 (8%) with P = 0.007; Table 5 counts 115 people without lung cancer and gives P = 0.0023.
  • The authors stated that, because of small sample size, they could not say the lung cancer patients did not have a worse prognosis than previously reported patients with non-asbestos-related lung cancer
• The authors' conclusion: The authors concluded that calcified plaque and interstitial changes occurring together on CT might be a predictor of lung cancer incidence
• Limitations the authors state:
  • Small numbers of people examined and of lung cancer cases, and a short postoperative observation period
  • Retrospective design

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: Lung Cancer, Occupational Exposure, Prognosis, CT Scan, Interstitial.

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