Comment on 'estimating the asbestos-related lung cancer burden from mesothelioma mortality' - IARC and chrysotile risks

Our plain-English summary of Comment on 'estimating the asbestos-related lung cancer burden from mesothelioma mortality' - IARC and chrysotile risks, by R.A. Lemen, A.L. Frank, C.L. Soskolne, et al (British Journal of Cancer, 2013).

The study

• Authors: R.A. Lemen, A.L. Frank, C.L. Soskolne, S.H. Weiss, B. Castleman
• Journal: British Journal of Cancer
• Published: 2013;109(3):823-5
• Type of article: Letter, Comment
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

In this letter, five authors responded to a 2012 British Journal of Cancer article by McCormack et al. that estimated the asbestos-related lung cancer burden from mesothelioma mortality. They argued that the article's estimates and conclusions were erroneous because it omitted newer data, relied on incomplete or outdated data, omitted critiques of data it used, and drew conclusions from heterogeneous data sets not adequately controlled for latency or exposure. On chrysotile, they stated that the article cited a 1990 study of the Balangero, Italy, mining cohort, which reported two mesothelioma cases in miners. It did not cite a 2008 update that found 27 mesothelioma cases associated with the site, including white-collar and environmental cases. They also stated that the article relied on a 1987 IARC evaluation rather than the 2012 IARC monograph, and on Hodgson and Darnton's 2000 potency estimates rather than their later revised estimates. They disputed the conclusion that mesotheliomas in chrysotile-exposed cohorts were due to other asbestos types. In support they cited animal studies, findings of chrysotile in the pleura, and a 1984 Ontario Royal Commission report. They also noted published criticisms of industry-sponsored Quebec research. They concluded that the article minimised chrysotile's risks and that its suggestion of 'strict regulation' conflicted with the World Health Organization's recommendation to stop all asbestos use. They also called its recommendation of smoking cessation only for formerly exposed workers inconsistent.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This was a letter to the editor, not a research study. Its authors criticised a 2012 article by McCormack and colleagues that estimated asbestos-related lung cancer from mesothelioma deaths. They argued it reached erroneous estimates and conclusions by omitting newer data. On chrysotile, they said the article left out a 2008 update by Mirabelli and colleagues on an Italian chrysotile mine. That update found 27 mesothelioma cases associated with the site, including miners, 'white collar' workers and environmental cases. Instead, they said, it cited a 1990 study reporting two cases in miners. They said it relied on outdated 1987 IARC data and did not adequately address latency or dose. They said it ignored revised 2009 potency estimates by Hodgson and Darnton and omitted criticisms of Quebec industry-sponsored research. They said its view that mesothelioma in chrysotile-exposed groups comes from other asbestos types rested on lung-burden analysis alone. They objected to its suggestion that strict regulation, rather than ending asbestos use, is acceptable. All the authors disclosed having been retained or having testified as expert witnesses in asbestos injury claims, usually for plaintiffs.

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 (commentary criticising a published article); no new data
• Who was studied: No study population; the letter comments on the 2012 British Journal of Cancer article by McCormack et al, 'Estimating the asbestos-related lung cancer burden from mesothelioma mortality'
• Exposure: Chrysotile asbestos, as treated in the McCormack et al (2012) article
• Main results:
  • The letter writers argued that McCormack et al omitted the 2008 Mirabelli et al update on the Italian chrysotile mining cohort. According to the letter, that update found a total of 27 mesothelioma cases associated with the mine site, including not only miners but also 'white collar' and environmental cases. The letter says McCormack et al cited instead the 1990 Piolatto et al study, which reported two mesothelioma cases in miners.
  • The letter writers argued that McCormack et al relied on outdated 1987 IARC data and did not adjust for or adequately address latency and dose.
  • The letter writers argued that McCormack et al cited earlier potency estimates by Hodgson and Darnton (2000). According to the letter, they ignored those authors' 2009 revised estimates, which lowered the potency differences between chrysotile and amphibole asbestos.
  • The letter writers argued that the McCormack et al conclusion that mesothelioma in chrysotile-exposed cohorts is due to other asbestos types lacked justification because it rested on lung-burden analysis alone.
  • The letter writers argued that McCormack et al omitted criticisms of the Quebec industry-sponsored research they referred to.
  • The letter writers argued that the McCormack et al article minimised chrysotile's health risks. In their view, its suggestion that strict regulation instead of eliminating asbestos use is acceptable contradicts the World Health Organization's recommendation to stop all asbestos use.
  • The letter writers called it inconsistent that McCormack et al encouraged smoking cessation only for formerly exposed workers and not for current asbestos workers.
• The authors' conclusion: The letter writers concluded that the McCormack et al article put forth erroneous estimates and conclusions. In their view, chrysotile's role in causing mesothelioma is continually reaffirmed.
• Limitations the authors state:
  • Conflict-of-interest statement: all the letter's authors disclosed having been retained by, and/or having testified as expert witnesses in, asbestos personal injury compensation claims, usually at the request of plaintiffs. They also disclosed roles with organisations that advocate an asbestos ban.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, IARC, Chrysotile, Latency, Pleura.

Related studies

• Reply: comment on 'estimating the asbestos-related lung cancer burden from mesothelioma mortality' — V. McCormack, J. Peto, et al. (2013)
• Estimating the asbestos-related lung cancer burden from mesothelioma mortality — V. McCormack, J. Peto, et al. (2012)
• How conflicted authors undermine the World Health Organization (WHO) campaign to stop all use of asbestos: spotlight on studies showing that chrysotile is carcinogenic and facilitates other non-cancer asbestos-related diseases — X. Baur, C.L. Soskolne, et al. (2015)
• An approach to estimating the environmental burden of cancer from known and probable carcinogens: application to Ontario, Canada — S.L. Greco, E. MacIntyre, et al. (2020)
• Occupational burden of asbestos-related cancer in Argentina, Brazil, Colombia, and Mexico — R. Pasetto, B. Terracini, et al. (2014)
• IARC monographs program on carcinogenicity of combined hormonal contraceptives and menopausal therapy — H.P. Schneider, A.O. Mueck, et al. (2005)

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