Frequency of Asbestos Exposure and Histological Subtype of Ovarian Carcinoma

Our plain-English summary of Frequency of Asbestos Exposure and Histological Subtype of Ovarian Carcinoma, by P. Vidican, O. Perol, J. Fevotte, et al (International Journal of Environmental Research and Public Health, 2022).

The study

• Authors: P. Vidican, O. Perol, J. Fevotte, E. Fort, I. Treilleux, E. Belladame, J. Zavadil, B. Fervers, B. Charbotel
• Journal: International Journal of Environmental Research and Public Health
• Published: 2022;19(9)
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The International Agency for Research on Cancer established a causal link between asbestos exposure and ovarian cancer. However, the exposure frequency and histological characteristics of asbestos-associated ovarian cancers remain to be investigated in detail. This multicenter case-case study assessed the asbestos exposure in ovarian carcinoma (OC) patients, alongside its association with histological subtype. Women were recruited in four hospitals in Lyon, France. Histological reports were reviewed by a pathologist. Patient and family members' data were collected by phone-based questionnaires. Asbestos exposure was defined as direct (occupational and environmental) and indirect (via parents, partners, and children). An industrial hygienist assessed the probability and level of exposure. The 254 enrolled patients (mean age 60 years) reported having an average of 2.3 different jobs (mean working duration 29 years). The prevalence of direct and indirect asbestos exposure was 13% (mean exposure duration 11 years) and 46%, respectively. High-grade serous carcinoma accounted for 73% of all OCs and 82% of histological subtypes in women with direct exposure. After adjustment on a familial history of OC, no significant associations between asbestos exposure (direct and/or indirect) and high-grade serous carcinoma were found. Women with OC had a high prevalence of asbestos exposure. Establishing risk profiles, as reported here, is important in facilitating compensation for asbestos-related OCs and for the surveillance of women at risk.

In plain English

This multicenter case–case study (EVAMOVAIRE) included 254 women with ovarian carcinoma from four hospitals in Lyon, France. The women were recruited in 2010–2013 and 2016–2018. They answered phone questionnaires about their own jobs and their relatives' jobs. An industrial hygienist judged the probability and level of each woman's asbestos exposure. The study did not report which asbestos fiber types the women encountered. The hygienist estimated that 34 women (13%) had been exposed at work, for a mean of 10.5 years, and that 117 (46%) had been exposed through family members. Both kinds of exposure were more common among women recruited in the earlier phase. Excluding eight women whose serous carcinoma was of undetermined grade, high-grade serous carcinoma made up 73% of cancers and 82% among directly exposed women. After adjusting for family history of ovarian cancer, the authors found no significant association between asbestos exposure and high-grade serous carcinoma. The study was not designed to measure whether asbestos raises ovarian cancer risk. The authors concluded that women with ovarian carcinoma had a high prevalence of asbestos exposure, and noted the study may have lacked statistical power.

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: Multicenter case–case study (EVAMOVAIRE) of ovarian carcinoma patients, with retrospective expert assessment of asbestos exposure by an industrial hygienist
• Who was studied: 254 women with newly diagnosed primary epithelial ovarian carcinoma at four hospitals in Lyon, France, recruited in two phases (2010–2013 and 2016–2018); mean age at interview 60.3 years
• Exposure: Asbestos (fiber type not specified), assessed as direct (occupational and environmental) or indirect (through the jobs of parents, partners and children). Probability was rated possible, probable or certain. Level was rated 1 (very low to low), 2 (low) or 3 (moderate to high, close to or above 0.1 f/mL).
• Main results:
  • 34 of 254 patients (13%) were estimated to have been occupationally exposed to asbestos, during 38 occupational periods
  • Mean duration of occupational asbestos exposure among exposed patients was 10.5 years
  • One patient was considered to have had only environmental exposure; as a child in Ukraine she lived next to a cement factory
  • 117 patients (46%) were estimated to have been exposed through their families; 98 patients (45%) were exposed only through family members
  • Among family-exposed patients, relatives of 107 (91%) brought work-clothes home, and 92 patients (86%) said they cleaned them
  • Direct occupational exposure was more frequent in patients recruited 2010–2013 than 2016–2018 (19% versus 8%, p = 0.009)
  • Exposure only through family was more frequent in patients recruited 2010–2013 than 2016–2018 (61% versus 29%, p less than 0.0001)
  • Excluding the 8 undetermined-grade serous carcinomas, high-grade serous carcinoma was 73% of all ovarian carcinomas, 82% among women with direct exposure and 72% among women with indirect exposure. In the full sample of 254 it was 180 patients (70.9%).
  • In unadjusted analysis, indirect exposure at a low level was associated with high-grade serous carcinoma: PR = 1.24, 95% CI 1.04–1.48, p = 0.08
  • After adjustment for family history of ovarian cancer, no significant association was found between asbestos exposure (direct and/or indirect) and high-grade serous carcinoma
• The authors' conclusion: The authors concluded that women with ovarian carcinoma have a high prevalence of asbestos exposure. They found no significant association with high-grade serous carcinoma, which they attributed either to lack of statistical power or to asbestos not being a specific risk factor for any histological subtype. They noted the study was not designed to estimate whether asbestos exposure raises ovarian cancer risk.
• Limitations the authors state:
  • The response rate (47%) was only moderate, and recruitment bias cannot be completely excluded
  • Patients who were ineligible because of death, deteriorating health or relapse may have had worse-prognosis cancers, possibly causing selection bias
  • Only 246 patients were analysed although 270 were needed, so the study may have lacked statistical power
  • The analysis of indirect exposure may have been too sensitive, because each patient was assigned the level of her most exposed relative
  • Family job information came from the patients, not the relatives, so some occupations may have been missed and prevalence underestimated
  • Information on other asbestos-related conditions such as plaques, pleurisy or fibrosis was not collected
  • Using mean exposure values over work periods may have smoothed out peak exposures
  • Reliable environmental and geographic asbestos information was not available in France and could not be assessed
  • Common exposures from domestic appliances and building materials were not considered

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Histological Subtype, Carcinoma, Ovarian Cancer.

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