Histologic type of lung cancer and asbestos exposure

Our plain-English summary of Histologic type of lung cancer and asbestos exposure, by O. Auerbach, L. Garfinkel, V.R. Parks, et al (Cancer, 1984).

The study

• Authors: O. Auerbach, L. Garfinkel, V.R. Parks, A.S. Conston, V.A. Galdi, L. Joubert
• Journal: Cancer
• Published: 1984;54(12):3017-21
• Cited by: 36 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. 000525).

Abstract

The histologic types of lung cancer in 855 patients (747 men and 107 women) from three hospitals and one international study of insulation workers were evaluated. Of these, 196 cases had asbestos exposure. About one half of the cases were diagnosed from surgical slides and one half from autopsy slides. Squamous cell carcinoma constituted the largest percentage of tumor types and was found with the same frequency in exposed and nonexposed groups. Small cell carcinoma was found in 25% of the exposed and in 15% of the nonexposed patients. Upper lung sites were involved in about two thirds of the cases with asbestos exposure and lower lobes in the other one third. There was little difference in histologic type in cases regardless of whether upper or lower lobes were involved. Cigarette smokers who smoked until their cancer diagnosis showed no difference in histologic type by amount smoked, and slight but not statistically significant differences from ex-cigarette smokers.

In plain English

This study compared the microscopic (histologic) types of lung cancer in people with and without occupational asbestos exposure. The authors reviewed 855 lung cancer cases in total (747 men and 108 women), from three New Jersey hospitals and from a study of insulation workers union members, which supplied 67 cases. Of these, 196 had occupational asbestos exposure and 659 did not. The article did not name asbestos fiber types. One author reclassified the slides without knowing who the patient was or whether they had been exposed. Squamous cell carcinoma made up 49.0% of exposed cases and 50.8% of nonexposed cases. Small cell carcinoma made up 24.5% of exposed and 15.4% of nonexposed cases. Adenocarcinoma made up 14.8% of exposed and 18.5% of nonexposed cases. The difference in the overall distribution of types was statistically significant. Among exposed cases with a recorded site, 98 tumors were in the upper lung and 51 in the lower lung. Tumor type did not differ significantly between upper and lower lobes. The authors concluded that squamous cell carcinoma was the most common type, with little difference between exposed and nonexposed cases.

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: Comparison of histologic type in lung cancer cases with and without asbestos exposure. Slides were reclassified blind by one of the authors.
• Who was studied: 855 lung cancer cases in total (747 men, 108 women), drawn from four sources. These were Somerset Medical Center, Somerville, New Jersey (1966-1978); St. Peter's Hospital, New Brunswick, New Jersey (1970-1979); and 256 deaths at the Veterans Administration Medical Center, East Orange, New Jersey (1966-1975). The fourth source was 67 insulation workers union cases (diagnosed 1967-1976), which are included in the 855 total.
• Exposure: Occupational asbestos exposure, fiber types not specified. There were 196 exposed and 659 unexposed cases. The exposed cases included 67 members of an insulation workers union.
• Main results:
  • Squamous cell carcinoma: 49.0% of the 196 asbestos-exposed cases versus 50.8% of nonexposed cases.
  • Small cell carcinoma: 24.5% of exposed cases versus 15.4% of nonexposed cases (Table 2 prints 15.5%).
  • Adenocarcinoma: 14.8% of exposed cases versus 18.5% of nonexposed cases.
  • The difference in the distribution of histologic types between exposed and nonexposed groups was statistically significant (P less than 0.05).
  • Among asbestos-exposed cases with a designated site, 98 tumors were in the upper lung and 51 in the lower lung.
  • In exposed cases, histologic type did not differ significantly between upper and lower lobes (P greater than 0.05).
  • In men who smoked up to their final illness, the proportion of each histologic type was virtually the same regardless of how many cigarettes they smoked per day.
  • Current and ex-cigarette smokers did not differ significantly in histologic type.
  • Only 10 of the 774 cases with verified smoking histories had never smoked.
  • Squamous cell carcinoma made up 37.7% of cases diagnosed from autopsy slides. It made up about 63% of cases diagnosed from surgical specimens (63.5% in the text, 63.4% in Table 6).
• The authors' conclusion: The authors concluded that squamous cell carcinoma was the most common lung tumor type, with little difference between people with and without asbestos exposure.
• Limitations the authors state:
  • Smoking histories could not be verified for 82 subjects, including most of the insulation worker (Mt. Sinai) group.
  • Tumor site was reviewed only for the asbestos-exposed cases, so it was not compared with nonexposed cases.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Asbestos Exposure, Insulator, Autopsy, Squamous Cell Carcinoma, Carcinoma.

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