Does asbestos exposure cause gastrointestinal cancer?

Our plain-English summary of Does asbestos exposure cause gastrointestinal cancer?, by D.S. Levine (Digestive Diseases and Sciences, 1985).

The study

• Author: D.S. Levine
• Journal: Digestive Diseases and Sciences
• Published: 1985;30(12):1189-98
• Type of article: Case report, Review
• Cited by: 19 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. 000486).

Abstract

The relationship between asbestos exposure and gastrointestinal malignancies is unlike the well-established correlation between occupational asbestos exposure and the subsequent development of pleuropulmonary neoplasms and mesotheliomas. Cohort studies on occupationally exposed workers suggest an association between asbestos and gastrointestinal cancer, but evaluation of dose-response, tissue analysis, animal experiment, and cell culture data yield inconsistent conclusions. No simplistic cause-effect relationship can be ascribed to asbestos at the present time, and the answer to the question, "Does asbestos exposure cause cancer?" must await the results of additional studies.

In plain English

This 1985 article was a review, not a new study. The author summarized published research on whether asbestos exposure is linked to gastrointestinal (digestive tract) cancer. The sources were studies of asbestos workers, communities with asbestos in drinking water, asbestos fibers in human tissue, animals fed asbestos, and cells in culture. The article also described one patient, a 43-year-old man who had worked two years as a shipyard welder from age 18 and later developed stomach adenocarcinoma. In the worker studies reviewed, relative risks for gastrointestinal cancer ranged between 1 and 4, against about 7 for lung and pleural cancer. An increased risk was reported among San Francisco residents using the most contaminated water source, but this was an exception among communities with contaminated water. Most animal feeding studies found no excess gastrointestinal cancer, and asbestos was not mutagenic in cell culture. The author noted weaknesses in the evidence, including death-certificate data, inconsistent control groups and crude dose estimates. The author concluded that no simple cause-effect relationship could be ascribed to asbestos and that additional studies were needed.

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: Review of published literature (epidemiologic, tissue analysis, animal and cell culture studies), introduced with a single case report
• Who was studied: Published studies of primarily or secondarily exposed asbestos workers and of populations with asbestos-contaminated water supplies, plus animal and cell culture studies; one case report of a 43-year-old man
• Exposure: Occupational asbestos exposure, including chrysotile, amosite and crocidolite in the worker studies tabulated; asbestos in drinking water; ingested asbestos in animal experiments
• Main results:
  • Across the asbestos worker studies reviewed, relative risk for gastrointestinal carcinoma ranged between 1 and 4, while relative risk for carcinoma of the lung and pleura in these workers was estimated at approximately 7
  • The reviewed studies noted a latency period of 20 to 40 years between exposure and development of gastrointestinal carcinoma in asbestos workers
  • An increased risk of gastrointestinal cancer was reported in the San Francisco population drinking water from the high-fiber source. The author described this as an exception: increased risk was usually not documented in other communities with contaminated drinking water (Duluth, Quebec, Connecticut, Florida, western Washington)
  • In most animal studies of ingested asbestos, no excess of gastrointestinal cancer was found, except in work with F344 rats
  • Studies reviewed had not shown a positive correlation between asbestos body counts in lung tissue and coincident lung or gastrointestinal cancer
  • In cell culture studies, asbestos was not mutagenic but did induce proliferative changes consistent with promoter-like activity
  • Case report: a 43-year-old man who had worked as a shipyard welder at age 18 for two years was found to have gastric adenocarcinoma with nodal metastases
• The authors' conclusion: The author concluded that epidemiologic data suggest asbestos workers are at increased risk of gut malignancy, but that evidence was not sufficient to suggest increased cancer risk in populations with asbestos-contaminated water. The author also concluded that no simplistic cause-effect relationship could be ascribed to asbestos at that time and that the question awaited additional studies
• Limitations the authors state:
  • Some worker studies collected data from death certificates rather than hospital or autopsy records
  • Choice of control groups in asbestos worker cohort studies was problematic and inconsistent
  • Dose estimates used in dose-response analyses were crude
  • The drinking-water population studies had many confounding variables
  • Animal models may be inappropriate because study intervals are shorter than human latency, and rats do not make asbestos bodies

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Neoplasm, Mesothelioma, Dose-response relationship.

Related studies

• Investigating possible effects of abestos in city water: surveillance of gastrointestinal cancer incidence in Duluth, Minnesota — B.S. Levy, E. Sigurdson, et al. (1976)
• An investigation of the use of asbestos cement pipe for public water supply and the incidence of gastrointestinal cancer in Connecticut, 1935-1973 — J.M. Harrington, G.F. Craun, et al. (1978)
• Cancer of the gastrointestinal tract and exposure to asbestos in drinking water among lighthouse keepers (Norway) — K. Kjaerheim, B. Ulvestad, et al. (2005)
• Asbestos exposure and lymphomas of the gastrointestinal tract and oral cavity — R. Ross, R. Dworsky, et al. (1982)
• Asbestos and gastrointestinal cancer. A review of the literature — R.W. Morgan, D.E. Foliart, et al. (1985)
• In vitro approaches for determining mechanisms of toxicity and carcinogenicity by asbestos in the gastrointestinal and respiratory tracts — B.T. Mossman (1983)

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