Familial malignant mesothelioma: a population-based study in central Italy (1980-2012)

Our plain-English summary of Familial malignant mesothelioma: a population-based study in central Italy (1980-2012), by V. Ascoli, E. Romeo, C. Carnovale Scalzo, et al (Cancer Epidemiology, 2014).

The study

• Authors: V. Ascoli, E. Romeo, C. Carnovale Scalzo, I. Cozzi, L. Ancona, F. Cavariani, A. Balestri, L. Gasperini, F. Forastiere
• Journal: Cancer Epidemiology
• Published: 2014;38(3):273-8
• Cited by: 26 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is a sporadic cancer linked to asbestos exposure. Its occurrence among blood relatives (familial mesothelioma) may point to genetic susceptibility or shared exposures. The burden of the familial disease is unknown. The aims of the study were to assess at population level the proportion of familial mesotheliomas among all mesotheliomas and to investigate the family history of cancer among relatives of mesothelioma cases. We actively searched familial clusters based on a mesothelioma registry from central Italy (5.5 million people, 10% of the Italian population) of the National Mesothelioma Register network (ReNaM) as well as a pathology-based archive. Among 997 incident mesotheliomas recorded in a 32-year-period (1980-2012), we detected 13 clusters and 34 familial cases, accounting for 3.4% of all mesotheliomas. The most common clusters where those with affected siblings and unaffected parents. Asbestos exposure was occupational (n=7 clusters), household (n=2), environmental (n=1), or not attributable for insufficient information (n=3). There were 25 additional cancers in nine families. Some were cancer sites for which there is sufficient evidence (lung and larynx) or limited evidence (stomach and colon) of causal association with asbestos. The results suggest potential genetic recessive effects in mesothelioma that interact with asbestos exposure, but it is not possible to estimate the specific proportion attributable to each of these components.

Copyright © 2014 Elsevier Ltd. All rights reserved.

In plain English

This population-based study looked for mesothelioma among blood relatives in central Italy. The authors used 997 mesothelioma cases: those in the Lazio regional mesothelioma registry for 2001–2012, plus 206 cases from a pathology archive for 1980–2000. They searched for families with two or more cases, using records, questionnaires and interviews, and recorded family cancer histories and asbestos exposure. They found 34 familial mesotheliomas in 13 families, 3.4% of all cases. Of these, 31 were pleural and three were peritoneal, all three in men. Affected siblings with unaffected parents made up 2.6% of all cases (26/997), and parent–offspring pairs made up 0.8% (8/997). Asbestos exposure was judged occupational in seven clusters, household in two and environmental in one, and could not be attributed in three. Crocidolite was found in lung tissue from one person. In nine families, 25 other cancers were recorded among 99 persons, including five lung cancers, all in men. The authors concluded that the findings are consistent with a possible genetic component, but that the shares due to heredity and to asbestos cannot be separated. They noted that cases may have been undercounted.

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: Population-based study of familial clusters of mesothelioma, identified from a regional mesothelioma registry and a pathology-based archive
• Who was studied: 997 mesothelioma cases from the Lazio region (including Rome), central Italy, an area covering about 5.5 million inhabitants. The cases were 791 registered by the regional registry (COR-Lazio) for 2001–2012 and 206 cases for 1980–2000 from a pathology-based archive (88% Lazio residents). Pedigrees covered 129 persons in 13 families.
• Exposure: Asbestos exposure assessed by standard questionnaire (patient or next of kin) and classified as occupational, household, environmental, hobbies, unlikely, unknown or unclassified. Fiber type was reported only for one person, whose lung tissue showed crocidolite.
• Main results:
  • 34 familial mesotheliomas in 13 families (13 probands) among 997 cases, a familial proportion of 3.4% of all mesotheliomas
  • Among the 34 familial cases, 31 were pleural mesothelioma and three were peritoneal mesothelioma (only men)
  • Male-to-female ratio was 1.6 among the familial cases and 2.3 among all other cases
  • Affected siblings whose parents did not have mesothelioma (horizontal pattern) made up 2.6% of all cases (26/997)
  • Parent–offspring clusters (vertical pattern) made up 0.8% of all cases (8/997); no family had affected parents with multiple affected offspring
  • Asbestos exposure was occupational in seven clusters, household in two, and environmental in one; information was insufficient in three clusters
  • Asbestos in lung tissue was documented in one cluster (Family I); one person had crocidolite with an elevated fiber burden and asbestos bodies
  • Family history of cancer was positive in nine families: among 99 persons there were 25 cancers, including five lung cancers, all in men (mean age 63 years)
• The authors' conclusion: The authors concluded that the findings are consistent with a potentially genetic component in mesothelioma development. They also concluded that, given interactions with asbestos exposure, the proportion due to heritable versus asbestos components cannot be estimated. They considered the above-3% familial proportion generalizable to populations with similar incidence rates.
• Limitations the authors state:
  • The number of mesotheliomas may have been underestimated, given the difficulty of reaching diagnostic certainty, especially in the past
  • The number of additional cancers in relatives might be underestimated
  • The authors could not estimate the relative risk of cancer in family members because they did not follow the entire cohort of family relatives

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: Malignant Mesothelioma, Asbestos Exposure, Mesothelioma, Pathology.

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