Gastrointestinal carcinoma and occurrence of pleural plaques on pulmonary X-ray

Our plain-English summary of Gastrointestinal carcinoma and occurrence of pleural plaques on pulmonary X-ray, by G. Hillerdal (Journal of Occupational Medicine., 1980).

The study

• Author: G. Hillerdal
• Journal: Journal of Occupational Medicine.
• Published: 1980;22(12):806-9
• Cited by: 6 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. 000816).

In plain English

This Swedish study asked whether people with digestive-tract cancer more often had pleural plaques on chest X-rays. The author describes these chest-lining changes as caused mainly by asbestos. Patients from the county of Uppsala with tumors of the esophagus, stomach, small and large intestine or rectum diagnosed from 1968 to 1972 were identified through the Swedish Cancer Registry. Their miniature chest films from a county health survey were compared with those of three controls of the same sex and age per patient, filmed in the same year. Among 386 men with films, 13 (3.4%) had plaques, against 20 (1.7%) of 1,158 male controls, a difference reported as statistically significant. Among the separate cancer sites, only stomach cancer showed a significant difference. Among women, only two had plaques, one patient and one control, so no conclusions could be drawn. The author noted that the strict X-ray criteria miss many plaques. The author concluded there was a slight but significant excess of plaques in gastrointestinal cancer patients, particularly stomach cancer.

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: Case-control comparison of how often pleural plaques appeared on chest X-rays of cancer patients versus matched controls. There were three controls per patient, of the same sex and age, with films taken in the same year.
• Who was studied: Patients from the county of Uppsala, Sweden, with gastrointestinal tumors (esophagus, stomach, small and large intestine, rectum) diagnosed 1968 to 1972, taken from the Swedish Cancer Registry. Men: 482 on the list, 61 of them with benign lesions only; films were found for 386 (80.1%), giving 1,158 controls. Women: 420 on the list; 320 had chest X-rays, giving 960 controls.
• Exposure: Asbestos exposure was not measured directly. Pleural plaques seen on chest X-ray were used as an indirect marker of asbestos exposure. No fiber types were named. Occupations stated on the X-ray cards of almost all men were recorded.
• Main results:
  • Men: pleural plaques were found in 13 of 386 tumor patients (3.4%) and in 20 of 1,158 controls (1.7%). The difference was reported as significant at the 2% level (chi-square test).
  • Men, by cancer site: apart from the overall figures, the difference was statistically significant only for stomach cancer.
  • Women: only two had plaques, one patient and one control. No conclusions could be drawn.
  • The 1.7% frequency of plaques among male controls was similar to the expected value for the county in 1976.
  • Stated occupations of patients and controls did not differ significantly, except for construction workers in relation to stomach cancer. The author offered this as an argument against low socioeconomic status explaining the result.
• The authors' conclusion: The authors concluded that there is a slight but significant excess of typical pleural plaques in patients with gastrointestinal carcinoma, particularly carcinoma of the stomach. They described this as in accordance with other reports linking asbestos exposure to an approximately doubled risk of gastrointestinal carcinoma.
• Limitations the authors state:
  • The strict X-ray criteria for plaques give few false positives compared with autopsy findings, but miss a large portion of plaques.

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Pleural Plaques.

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