Geographic Co-Occurrence of Mesothelioma and Ovarian Cancer Incidence

Our plain-English summary of Geographic Co-Occurrence of Mesothelioma and Ovarian Cancer Incidence, by S.J. Henley, L.A. Peipins, S.H. Rim, et al (Journal of Women's Health, 2020).

The study

• Authors: S.J. Henley, L.A. Peipins, S.H. Rim, T.C. Larson, J.W. Miller
• Journal: Journal of Women's Health
• Published: 2020;29(1):111-118
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Asbestos is an established cause of several cancers, including mesothelioma and ovarian cancer. Incidence of mesothelioma, the sentinel asbestos-associated cancer, varies by state, likely reflecting different levels of asbestos exposure. We hypothesized that states with high mesothelioma incidence may also have high ovarian cancer incidence. Materials and Methods: Using data from the Centers for Disease Control and Prevention National Program for Cancer Registries and the National Cancer Institute Surveillance, Epidemiology, and End Results Program, we examined the geographic co-occurrence of mesothelioma and ovarian cancer incidence rates by U.S. state for 2003-2015. Results: By state, mesothelioma incidence ranged from 0.5 to 1.3 cases per 100,000 persons and ovarian cancer incidence ranged from 9 to 12 cases per 100,000 females. When states were grouped by quartile of mesothelioma incidence, the average ovarian cancer incidence rate was 10% higher in states with the highest mesothelioma incidence than in states with the lowest mesothelioma incidence. Ovarian cancer incidence tended to be higher in states with high mesothelioma incidence (Pearson correlation r = 0.54; p < 0.0001). Conclusions: Data from state cancer registries show ovarian cancer incidence was positively correlated with mesothelioma incidence, suggesting asbestos may be a common exposure. The potential for asbestos exposure has declined since the 1970s because fewer products contain asbestos; however, some products, materials, and buildings may still release asbestos and thousands of workers may be exposed. Ensuring that people are protected from exposure to asbestos in their workplaces, homes, schools, and communities may reduce the risk of several cancers.

In plain English

This was an ecologic study: it compared cancer rates across U.S. states rather than following individual people. Using cancer registry data covering all states and the District of Columbia for 2003 to 2015, the authors asked whether states with more mesothelioma, which they call a sentinel asbestos-related cancer, also had more ovarian cancer. Asbestos exposure itself was not measured. State mesothelioma rates ranged from 0.5 to 1.3 cases per 100,000 persons, and ovarian cancer rates ranged from about 9 to 12 per 100,000 females. The average ovarian cancer rate was 10% higher in the quarter of states with the highest mesothelioma rates than in the quarter with the lowest. Across states, the two rates were positively correlated (r = 0.54, p less than 0.0001). Correlations were also seen for serous, endometrioid and clear cell ovarian cancers, but not for stromal or germ cell tumors. The authors concluded that this suggests asbestos may be a common exposure. They also wrote that a causal association with asbestos cannot be inferred from this kind of analysis.

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: Ecologic analysis comparing state-level cancer incidence rates from population-based cancer registries
• Who was studied: Microscopically confirmed invasive ovarian cancers and mesotheliomas reported to U.S. cancer registries (CDC National Program of Cancer Registries and NCI SEER) in all 50 states and the District of Columbia, 2003 to 2015. These registries covered 100% of the U.S. population.
• Exposure: No individual asbestos exposure was measured. State mesothelioma incidence was used as a marker of asbestos exposure and compared with state ovarian cancer incidence. No specific fiber types were studied.
• Main results:
  • Nationally, an average of 19,830 microscopically confirmed invasive ovarian cancers were reported each year (11.2 cases per 100,000 females).
  • Nationally, an average of 3,043 microscopically confirmed mesotheliomas were reported each year (0.94 cases per 100,000 persons). Rates were higher in males (1.7 per 100,000 males) than in females (0.4 per 100,000 females).
  • By state, ovarian cancer incidence ranged from about 9 to 12 cases per 100,000 females, and mesothelioma incidence ranged from 0.5 to 1.3 cases per 100,000 persons.
  • With states grouped into quartiles of mesothelioma incidence, the average ovarian cancer rate was 10% higher in the highest-mesothelioma states than in the lowest-mesothelioma states.
  • When stromal and germ cell tumors were excluded, ovarian cancer rates were 6% lower in each quartile, but a similar relationship with mesothelioma incidence was observed. The data for this check were not shown.
  • Across states, ovarian cancer incidence was positively correlated with mesothelioma incidence (Pearson correlation r = 0.54; p less than 0.0001).
  • Restricting to pleural mesothelioma gave a similar correlation (r = 0.54; p less than 0.0001).
  • Mesothelioma incidence was significantly positively correlated with three ovarian cancer subtypes: endometrioid carcinoma (r = 0.55; p less than 0.0001), clear cell carcinoma (r = 0.51; p = 0.0002) and serous carcinoma (r = 0.48; p = 0.0004).
  • There was no significant correlation for stromal tumors (r = 0.10; p = 0.4644) or germ cell tumors (r = 0.13; p = 0.3585).
• The authors' conclusion: The authors concluded that ovarian cancer incidence was positively correlated with mesothelioma incidence across states, suggesting asbestos may be a common exposure.
• Limitations the authors state:
  • Because people migrate, state rates may not reflect where asbestos exposure occurred, especially given the long latency between exposure and disease.
  • As an ecologic analysis, it cannot establish that asbestos exposure caused the ovarian cancers.
  • Rates were based on whole states; analyses of smaller areas might find a stronger or different association.
  • Some peritoneal mesotheliomas may be misdiagnosed as ovarian cancer, or the reverse. The authors restricted the analysis to microscopically confirmed cases to reduce this.

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: Mesothelioma, Ovarian Cancer, Asbestos Exposure, Epidemiology, Incidence.

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