European Journal of Cancer Prevention

Our medical research library holds 25 studies published in European Journal of Cancer Prevention (1991–2025). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 23 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 2 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: Lippincott Williams & Wilkins
• Published: 1991 to the present, England
• Language: English
• ISSN: 0959-8278 (print), 1473-5709 (electronic)
• Its record in the NLM Catalog

2020s

• Global, regional, and national burden of ovarian cancer among young women during 1990-2019. Q. Zhuang, G. Gu, J. Chen, et al. 2025;34(1):1-10. PubMed · Publisher · Free full text

  Abstract

  Background: Ovarian cancer, the most devastating tumor in women globally, significantly impacts young women, compromising their daily lives and overall well-being. Ovarian cancer represents a significant public health concern due to its extensive physical and psychological consequences.

  Material And Methods: Data from the Global Burden of Disease were used to assess the global, regional, and national burden of ovarian cancer in young women aged 20-39 from 1990 to 2019. This analysis focused on trends measured by the estimated annual percentage change and explored the socioeconomic impacts via the socio-demographic index (SDI).

  Results: During 1990-2019, the incidence and prevalence of ovarian cancer among young women increased globally, with annual rates of 0.74% and 0.89%, respectively. The mortality rate and disability-adjusted life years also rose annually by 0.20% and 0.23%, respectively. A significant burden shift was observed toward regions with lower SDI, with high fasting plasma glucose, BMI, and asbestos exposure identified as prominent risk factors, particularly in lower SDI regions.

  Conclusion: Our findings underscore ovarian cancer in young women as an escalating global health challenge, with the burden increasingly shifting toward lower socioeconomic areas. This underscores the necessity for targeted prevention and control strategies for ovarian cancer, focusing on reducing the identified risk factors and ensuring equitable health resource distribution.

  Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

• Mesothelioma among seamen: a systematic review and meta-analysis. M. Rota, A. Viscardi, F. Maghin, et al. 2024;33(5):438-447. Systematic review · Meta-analysis PubMed · Publisher

  Abstract

  Objectives: Navy personnel and seafarers live and work 24 h per day in the shipboard environment and they are exposed to asbestos fibers released into the confined spaces aboard ships. We conducted a systematic review and meta-analysis to quantify the mesothelioma risk of seamen working aboard ships, either commercial or naval vessels, as compared to that of the general population.

  Methods: We carried out a literature search in MEDLINE through PubMed and EMBASE, from inception to 31 December 2021, of all studies on seamen working aboard ships, either commercial or naval vessels, characterized by exposure to asbestos and providing mesothelioma risk estimates. The Newcastle-Ottawa Scale was used to assess the quality of the studies included. The pooled standardized mortality ratio (SMR) was computed across eligible studies. The study protocol was registered on PROSPERO and reporting followed the preferred reporting items for systematic reviews and meta-analyses guidelines.

  Results: A total of 10 studies published from 1990 to 2020 were considered eligible and included in the systematic review and meta-analysis. All the included studies were of good quality, with a median score of seven out of nine. Overall, there were 235 mesothelioma cases/deaths in the included studies versus 115.6 expected, with a pooled SMR of 2.11 (95% confidence intervals, 1.70-2.62), in the absence of a significant between-study heterogeneity ( I2 = 39%, P = 0.11).

  Conclusion: A more than double excess risk for mesothelioma among seamen working aboard ships emerged from our meta-analysis.

  Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

• Occupational exposure register-based cohort study on mortality among asbestos-related workers in Italy after the ban. A. Scarselli, M. Corfiati, A. Marinaccio. 2023;32(3):281-285. PubMed · Publisher

  Abstract

  Objective: Asbestos is a human carcinogen and can cause some types of cancer, including mesothelioma. A relevant number of workers are still engaged in asbestos removal and disposal activities, whose actual risk of asbestos-related diseases is still scarcely recognized. The main objective of this study is to assess the cause-specific mortality among workers involved in asbestos removal and disposal after the ban in Italy.

  Methods: Data from the Information System on Occupational Exposure to carcinogens (SIREP) in the period 1996-2018 were selected. Proportionate mortality ratios (PMRs) by cause of death were calculated by linking exposure occupational information to national mortality statistics (2005-2018), assuming a Poisson distribution of the data.

  Results: A total of 142 deaths (all men) were identified among 13 715 asbestos removal and disposal workers. A significant excess ( P < 0.05) of mesothelioma deaths was found among male workers, about five-fold the expected. A significant increase in the mortality ratio was also found for malignant melanoma of skin.

  Conclusions: A risk of mesothelioma has been found among workers involved in asbestos removal and disposal. Epidemiological surveillance and promotion of prevention action plans are highly recommended for workers engaged in asbestos removal and disposal activities, to ensure compliance with regulatory requirements and reduce the still relevant risk of contracting the related tumor pathology.

  Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

• Reactive oxygen species-regulating proteins peroxiredoxin 2 and thioredoxin, and glyceraldehyde-3-phosphate dehydrogenase are differentially abundant in induced sputum from smokers with lung cancer or asbestos exposure. A.M. Rostila, S.L. Anttila, M.M. Lalowski, et al. 2020;29(3):238-247. PubMed · Publisher

  Abstract

  Lung cancer is a deadly disease, typically caused by known risk factors, such as tobacco smoke and asbestos exposure. By triggering cellular oxidative stress and altering the antioxidant pathways eliminating reactive oxygen species (ROS), tobacco smoke and asbestos predispose to cancer. Despite easily recognizable high-risk individuals, lung cancer screening and its early detection are hampered by poor diagnostic tools including the absence of proper biomarkers. This study aimed to recognize potential lung cancer biomarkers using induced sputum noninvasively collected from the lungs of individuals in risk of contracting lung cancer. Study groups composed of current and former smokers, who either were significantly asbestos exposed, had lung cancer, or were unexposed and asymptomatic. Screening of potential biomarkers was performed with 52, and five differentially abundant proteins, peroxiredoxin 2 (PRDX2), thioredoxin (TXN), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), extracellular matrix protein 1 (ECM1), and protein S100 A8 (S100A8), were chosen to undergo validation, for their previously known connection with oxidative stress or cancer. Results from the validation in 123 sputa showed that PRDX2, TXN, and GAPDH were differentially abundant in sputa from individuals with lung cancer. TXN had a negative correlation with asbestos exposure, yet a positive correlation with smoking and lung cancer. Thus, tobacco smoking, asbestos exposure, and lung carcinogenesis may disturb the cellular redox state in different ways. A strong correlation was found among PRDX2, TXN, GAPDH, and S100A8, suggesting that these proteins may present a diagnostic biomarker panel to aid recognizing individuals at high risk of contracting lung cancer.

2010s

• Survival of solid cancer patients in France, 1989-2013: a population-based study. A. Cowppli-Bony, Z. Uhry, L. Remontet, et al. 2017;26(6):461-468. PubMed · Publisher

  Abstract

  This study provides updates of net survival (NS) estimates at 5, 10, and 15 years as well as survival trends for 35 solid cancers in France using data from 19 population-based cancer registries. The study considered all cases of solid cancer diagnosed between 1989 and 2010 in patients older than 15 years of age who were actively followed up until 30 June 2013. NS was estimated using the Pohar-Perme method. The age-standardized NS used the international cancer survival standard weights. The 5-year age-standardized NSs ranged from 4% (pleural mesothelioma) to 93% (prostate) in men and from 10% (pancreas) to 97% (thyroid) in women. The 10-year age-standardized NSs ranged from 2% (pleural mesothelioma) in both sexes to 95% (testis) in men and 91% (thyroid) in women. The most frequent cancers (namely, breast and prostate cancers) had the highest NSs: 87 and 93% at 5 years and 78 and 84% at 10 years, respectively. Several cancers (especially lung, pancreas, and liver cancer) had very poor prognoses (5-year NSs under 20%). Fifteen-year NSs remained high for testis cancer. In most cancers, 5- and 10-year age-standardized NSs increased between 1989 and 2010. Advanced age was associated with a poor prognosis and little improvement in survival. The increases in cancer survival are probably related to earlier diagnosis and therapeutic advances over the last decade. However, poor prognoses are still found in some alcohol-related and tobacco-related cancers and in elderly patients, highlighting the need for more prevention, diagnosis, and treatment efforts.

• Time trends and spatial patterns in the mesothelioma incidence in Slovenia, 1961-2014. V. Zadnik, M. Primic Zakelj, K. Jarm, et al. 2017;26 Joining forces for better cancer registration in Europe:S191-S196. PubMed · Publisher

  Abstract

  We aimed to explore the temporal and spatial variations in mesothelioma incidence in Slovenia for the last 50 years and, among these, to evaluate the consequences of asbestos usage. The incidence data from the population-based Cancer Registry of Republic of Slovenia for the period 1961-2014 were analysed. The data of asbestos imported to Slovenia were used as a proxy for asbestos exposure in manufacturing areas. Log-linear joinpoint regression and age-period-cohort Poisson models were used in the time-trend analysis. The mesothelioma maps were produced according to the method of local standardized incidence ratio estimates and are presented together with the map of Slovenian major asbestos-exposed locations. The maximum value of the asbestos import curve corresponds to the peak of mesothelioma curve exactly 30 years later. Both increases before the peak are comparable in time interval and steepness. The highest mesothelioma risk was detected for the cohort born between 1940 and 1944. In maps, the mesothelioma clusters manifest around known asbestos sources predominantly in the years 1980-1990, but in the last few years, the geographical distribution is more dispersed. The data from our long-existing population-based cancer registry provide a good insight into the on-going mesothelioma epidemic in Slovenia. Our results imply that the mesothelioma peak has already been reached in Slovenia. In the future, new cases will emerge more randomly throughout the country.

• Cancer incidence, trends, and survival among immigrants to Sweden: a population-based study. S.M. Mousavi, K. Hemminki. 2015;24 Suppl 1:S1-S63. PubMed · Publisher

  Abstract

  This review aimed at covering cancer risk trends by site and histology in first-generation and second-generation immigrants in Sweden compared with natives. In addition, we reviewed data on cancer survival in immigrants to explore factors explaining cancer survival in the entire population. The Swedish Family-Cancer Database was used to calculate standardized incidence ratios and hazard ratios (HRs) of death from cancer in 77,360 and 993,824 cases among first-generation, and 4356 and 263,485 cases among second-generation immigrants and Swedes, respectively. Ordinal logistic regression analyses were used to calculate odds ratio. To obtain the maximum number of cases, we classified the immigrants according to geographical setting, population, and/or cancer risk. Compared with native Swedes, the highest risk of cancer was observed for nasopharyngeal carcinoma in Southeast Asian men (standardized incidence ratio=35.6) and women (24.6), for hypopharyngeal carcinoma in Indian men (5.4), for squamous-cell carcinoma of the esophagus in Iranian women (3.8), for cardia of the stomach in East Asian women (4.2), for signet-ring cell carcinoma of the stomach in Southeast Asian women (6.7), for the liver in East Asian men (6.8), for the gall bladder in Indian women (3.8), for the pancreas in North African men (2.2), for large cell carcinoma of the lung in former Yugoslavian men (4.2), for pleural mesothelioma in Turkish women (23.8), for the cervix in Danes (1.6), for seminoma in Chileans (2.1), for transitional-cell carcinoma of the bladder in Asian Arab men (2.3), for meningioma in former Yugoslavians (1.3), and for papillary carcinoma of the thyroid in East and Southeast Asian men (3.6). No immigrant groups had an increased risk of breast, uterus, ovary, and prostate cancers or nervous system tumors. The HRs for all breast cancers were between 1.0 in low-risk Europeans and 1.2 in lowest-risk non-Europeans. Low-risk non-Europeans had an HR of 2.9 for lobular carcinoma. Low-risk non-Europeans were diagnosed in a higher T-class (odds ratio=1.9) than Swedes. The HRs for prostate cancer were 0.6 in Turks, Middle Easterners, Asians, and Chileans. In conclusion, environmental and behavioral factors, early-childhood exposures, and infections may play a major role in the risk of esophageal, stomach, liver, nasopharyngeal and hypopharyngeal cancers, malignant pleural mesothelioma, breast, gynecological, testicular, urinary bladder, and thyroid cancers. Pancreatic cancer and nervous system tumors may have a major genetic component in the etiology. The ethnic differences in the risk of breast cancer by histology had no major influence on survival. Middle Easterners, Asians, and Chileans, with the lowest risk of prostate cancer, also had the most favorable survival, suggesting a biological mechanism for this finding.

• A critique of a review on the relationship between asbestos exposure and the risk of mesothelioma: reply. C. La Vecchia, P. Boffetta. 2014;23(5):494-6. Letter · Comment PubMed · Publisher

  Summary

  In this letter, La Vecchia and Boffetta replied to Terracini and colleagues' critique of their 2012 review on how stopping exposure, and recent exposure, to asbestos affects mesothelioma risk. They stated that the review addressed cessation of exposure, not duration of exposure. They noted that the critics had not named any omitted study reporting results by time since cessation. For the Italian asbestos cement cohort (Magnani et al., 2008), they said their reading matched the original authors' report of a non-significant trend toward reduced risk more than 15 years after cessation. They described the Italian asbestos textile cohort (Pira et al.) as informative because 54% of workers were women and 33 of 68 mesothelioma deaths occurred in workers employed less than 5 years. They combined pleural and peritoneal cases there because the SMRs were similar (46 and 37). They said the UK case-control results by duration were not adjusted for latency. For the Great Britain Asbestos Survey, they called left-censoring a common limitation. They reported a relative risk of 0.99 both at 30 or more years since last exposure (one death) and at 20-30 years (89 deaths). They agreed that pleural and peritoneal mesothelioma should be distinguished. They concluded that their review adequately summarized the limited data. Both authors declared serving as expert witnesses for defendants, and one also for a judge, in asbestos-related criminal trials.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• A critique to a review on the relationship between asbestos exposure and the risk of mesothelioma. B. Terracini, D. Mirabelli, C. Magnani, et al. 2014;23(5):492-4. Letter · Comment PubMed · Publisher

  Summary

  This letter to the editor responded to a 2012 review by La Vecchia and Boffetta, which concluded that the risk of mesothelioma is not influenced by later exposure to asbestos or by stopping exposure. The authors said the review was not systematic and misread their own cohort study of Eternit asbestos-cement workers in Casale Monferrato, Italy. In that study, the category of workers who stopped exposure less than 3 years before death also included person-years accrued during employment, which made its risk appear artificially low. The other categories suggested a decreasing trend with longer time since exposure ended. The review also omitted the steady increase in rate ratio with duration of exposure: each year of exposure was associated with a 5% increase in mesothelioma risk. The authors argued that the SIA textile cohort estimates were unstable (for example, an SMR of 54.3 based on five cases) and confounded by exposure intensity. They described results from a UK case-control study as contradictory. They said the Great Britain Asbestos Survey gave no valid information beyond 30 years after exposure ended (one case). They concluded that the review's conclusions were not supported by the original studies. Several authors declared that they had acted as expert witnesses in asbestos criminal trials.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Role of stopping exposure and recent exposure to asbestos in the risk of mesothelioma. C. La Vecchia, P. Boffetta. 2012;21(3):227-30. Review PubMed · Publisher

  Abstract

  The model of asbestos-related mesothelioma implies that the time since first exposure (latency) is the key determinant of subsequent risk. The role of recent exposure or stopping asbestos exposure, if any, is, however, open to discussion. A literature review was conducted to the end of 2010. In a cohort of 1966 Italian textile workers, the standardized mortality ratio, on the basis of 68 deaths from mesothelioma, was 6627 for workers employed only under the age of 30 years, 8019 for those employed both under the age of 30 years and at the age of 30-39 years, and 5891 for those employed both under the age of 30 years and at the age of 40 years or more. In a cohort of Italian asbestos cement workers, including 135 deaths from pleural cancer, compared with workers who had stopped exposure for 3-15 years, the relative risk (RR) was similar for those still employed (RR=0.67) and for those who had stopped for 30 years or more (RR=0.65). In a British case-control study, including 622 cases of mesothelioma and 1420 population controls, the RR substantially increased with increasing duration of exposure under the age of 30 years, but not with exposure at the age of more than 30 years. In the Great Britain Asbestos Workers Survey, including 649 deaths from mesothelioma compared with workers who were still employed and or had stopped for less than 10 years, the multivariate RRs were 0.90 10-20 years after stopping exposure and 0.99 both 20-30 and more than 30 years after stopping. There is consistent evidence showing that, for workers exposed in the distant past, the risk of mesothelioma is not appreciably modified by subsequent exposures, and that stopping exposure does not materially modify the subsequent risk of mesothelioma.

• Perineal talc use and ovarian cancer risk: a case study of scientific standards in environmental epidemiology. M. Huncharek, J. Muscat. 2011;20(6):501-7. Review PubMed · Publisher

  Abstract

  A number of observational studies (largely case-control) conducted over the last two decades suggest an association between use of talc powders on the female perineum and increased risk of ovarian cancer. A subset of these reports shows a roughly 30-60% increased risk of ovarian cancer associated with perineal talc exposure. A number of researchers partly base their conclusions of an association on the '…chemical relationship between talc and asbestos', the latter substance being a known human carcinogen. Although separating causal from noncausal explanations for an observed statistical association is a difficult process, there currently exist commonly accepted guidelines by which such inferences can be made. These scientific approaches include consideration of the strength of the association, the consistency of the finding across studies, and existence of a biological explanation of the observed phenomenon, among others. When applied to the context of a proposed talc/ovarian cancer association, we conclude that the weak statistical associations observed in a number of epidemiological studies do not support a causal association.

• Retinol supplementation and mesothelioma incidence in workers earlier exposed to blue asbestos (Crocidolite) at Wittenoom, Western Australia. H.S. Alfonso, A. Reid, N.H. de Klerk, et al. 2010;19(5):355-9. PubMed · Publisher

  Abstract

  Owing to the high rates of malignant mesothelioma in workers exposed to crocidolite earlier at Wittenoom and evidence of protection against cancer by vitamin A, a population-based cancer prevention programme providing retinol supplements (25 000 IU/day) was commenced in 1990. The former workers at Wittenoom known to be alive and living in Western Australia in June 1990 constitute the study population. The participants were classified into two groups: those who received supplemental retinol (intervention group) and those who received none (comparison group). The relative rate of mesothelioma for those receiving retinol was estimated using Cox regression, adjusting for cumulative asbestos exposure and age at first exposure to asbestos. Nine hundred and twenty-eight former Wittenoom workers received retinol at some stage of the programme, whereas 1471 workers never received retinol (comparison group). Those who received retinol were younger, had a greater exposure to asbestos and smoked less than the comparison group. There were 65 cases of mesothelioma in the retinol group and 88 in the comparison group. After adjustment, the hazard ratio was 0.99 (95% confidence interval=0.70-1.41). This result did not alter when the participants who received only retinol once or those who received beta-carotene earlier were excluded from the analysis. In conclusion, this study provides little support for possible preventive effects of retinol against mesothelioma in workers exposed to blue asbestos.

2000s

• Psychological impact of computed tomography screening for lung cancer and occupational pulmonary disease among asbestos-exposed workers. T. Vierikko, S. Kivistö, R. Järvenpää, et al. 2009;18(3):203-6. PubMed · Publisher

  Abstract

  The objective of this study was to investigate the psychological impact of screening for lung cancer and occupational pulmonary disease among asbestos-exposed workers. Altogether, 633 workers were screened with chest computed tomography (627 men, 6 women, mean age 64.5 years). Participants' views on the necessity of screening,awareness of asbestos-exposure risks, their perceived lung cancer risk, trial adherence intention, health anxiety,and worry about lung cancer were assessed. Health anxiety was reduced significantly after screening (P < 0.001). After 1 year, no significant long-term psychological differences were found between those who immediately received clear results and those who were submitted to additional examinations because of positive findings. In conclusion,computed tomography screening of pulmonary disease was well accepted and did not produce excessive long-term anxiety or other negative psychological effects,which could prevent the participation in the future screening programs.

• The health impact of nonoccupational exposure to asbestos: what do we know?. M. Goldberg, D. Luce. 2009;18(6):489-503. Review PubMed · Publisher · Free full text

  Abstract

  The objective of this study was to examine the epidemiological data that confirm the risks of pleural mesothelioma, lung cancer, and other respiratory damage associated with nonoccupational exposure to asbestos, in circumstances where exposure levels are usually lower than those found in the workplace: domestic and paraoccupational exposure to asbestos-containing material among people living with asbestos workers or near asbestos mines and manufacturing plants, environmental exposure from naturally occurring asbestos in soil, and nonoccupational exposure to asbestos-containing material in buildings. Studies concerning natural asbestos in the environment show that the exposure that begins at birth does not seem to affect the duration of the latency period, but the studies do not show whether early exposure increases susceptibility; they do not suggest that susceptibility differs according to sex. Solid evidence shows an increased risk of mesothelioma among people whose exposure comes from a paraoccupational or domestic source. The risk of mesothelioma associated with exposure as result of living near an industrial asbestos source (mines, mills, asbestos processing plants) is clearly confirmed. No solid epidemiological data currently justify any judgment about the health effects associated with passive exposure in buildings containing asbestos. Most of the studies on nonoccupational sources reported mainly amphibole exposure, but it cannot be ruled out that environmental exposure to chrysotile may also cause cancer. Nonoccupational exposure to asbestos may explain approximately 20% of the mesotheliomas in industrialized countries, but it is does not seem possible to estimate the number of lung cancers caused by these circumstances of exposure.

• Perineal talc use and ovarian cancer: a critical review. J.E. Muscat, M.S. Huncharek. 2008;17(2):139-46. Review PubMed · Publisher · Free full text

  Abstract

  Talc, like asbestos, is a silicate that has been studied in relation to cancer risk. Several studies conducted over the past 25 years found an association between perineal talc powders and ovarian cancer. The summary relative risk is about 1.3 (95% confidence intervals 1.2-1.5) and these data have been interpreted as supporting a causal role. In this review article, we discuss the chemical and morphological features of talc and asbestos, and explain why despite their similar chemical classification talc does not possess asbestos-like carcinogenic properties. The heterogeneity in the perineal dusting studies has raised important concerns over the validity of the exposure measurements, and the lack of a consistent dose-response effect limits making causal inferences. Perhaps more importantly, whereas it is unknown whether external talc dust enters the female reproductive tract, measures of internal talc exposure such as talc-dusted diaphragms and latex condoms show no relationship with ovarian cancer risk. In addition, the therapeutic use of high dose cosmetic grade talc for pleurodesis has not been shown to cause cancer in patients receiving these treatment modalities. Talc is not genotoxic. Mechanistic, pathology and animal model studies have not found evidence for a carcinogenic effect. In summary, these data collectively do not indicate that cosmetic talc causes ovarian cancer.

• US mesothelioma patterns 1973-2002: indicators of change and insights into background rates. M.J. Teta, P.J. Mink, E. Lau, et al. 2008;17(6):525-34. PubMed · Publisher

  Abstract

  Mesothelioma rates are declining toward background levels, although estimates of the background rate have varied. We expanded upon earlier analyses and provided a data-based estimate of the background rate. We analyzed US male and female patterns for five age groups using the National Cancer Institute's Surveillance Epidemiology and End Results registry data from 1973 to 2002. Age-specific and age-adjusted incidence rates per 1 000 000 persons per year, standardized to the 2000 US population, were calculated for total, pleural, and peritoneal mesothelioma. We also calculated rates for persons who attained working age after the US Occupational Safety and Health Administration asbestos exposure limits took effect. Mesothelioma rates observed among young males and females varied little over time. We observed a decline and convergence of recent male and female rates in older age groups, except those who are between the age of 60 and above, for whom the 2002 male rate was approximately five times greater than that of females. As expected, rates were higher in major shipyard areas on the West coast. Rates for persons with little or no opportunity for occupational asbestos exposure were 1.15 (95% confidence interval: 0.90-1.45) for men and 0.94 (95% confidence interval: 0.87-1.24) for women. Mesothelioma is rare in younger age groups, and rates have been relatively stable and similar for both sexes. Rates continue to decline in older age groups, but remain high for males at 60 years or older. Rates among females at older ages suggest an impact of occupational exposure. The background rate for persons below age 50 is approximately one per million, independent of sex. Future data are needed to estimate this rate for older age groups.

• Plasma vitamin concentrations and incidence of mesothelioma and lung cancer in individuals exposed to crocidolite at Wittenoom, Western Australia. H.S. Alfonso, L. Fritschi, N.H. de Klerk, et al. 2006;15(4):290-4. PubMed · Publisher

  Abstract

  Increased rates of death from asbestos-related diseases have been reported in former workers and residents exposed to crocidolite (blue asbestos) at Wittenoom (Western Australia). The relationships between plasma concentrations of retinol, carotene and vitamin E and incidence of mesothelioma and lung cancer in a cohort of people from this town were examined. The relationships were evaluated by survival analyses using data obtained at the first visit, at each visit and with the rate of change of each vitamin during the period of follow-up. Of 1953 study participants, 65 developed mesothelioma during the follow-up, and 47 developed lung cancer. A lower incidence of mesothelioma was related to plasma concentrations of retinol at the first visit [hazard ratio (HR)=0.63, 95% confidence interval=0.41-0.99], and to measurements at each visit (HR=0.71, 95% confidence interval=0.50-1.00). Plasma carotene concentrations at the first measurement, but not during the follow-up period, were associated with lower incidence of lung cancer in men and in workers. No significant associations were found between carotene concentrations and incidence of mesothelioma. Vitamin E concentrations were not significantly associated with mesothelioma or lung cancer incidence. These findings suggest that people with chronically low plasma levels of retinol have increased risk of developing mesothelioma and lung cancer.

• Spatial variation of mortality for common and rare cancers in Piedmont, Italy, from 1980 to 2000: a Bayesian approach. M. Maule, F. Merletti, D. Mirabelli, et al. 2006;15(2):108-16. PubMed · Publisher

  Abstract

  A Bayesian hierarchical model was used to study the spatial variation in mortality risk from lung and pleural cancer in both sexes, and breast and soft tissue sarcoma (STS) in women in Piedmont (north-west Italy, average population 4 349 411) from 1980 to 2000. Of these four neoplasms, two are common (lung and breast) and two rare (pleura and STS); two have well recognized risk factors (lung and pleura) while the other two (breast and STS) have no single strong risk factor. Data were analysed at a small-area level (1206 municipalities, population 39 to 989 663), using both standardized mortality ratios and Bayesian-estimated mortality risks. The Bayesian model allowed for both heterogeneity (through spatially independent random effects) and clustering (through spatially correlated random effects) and, by borrowing information from neighbouring areas, provided stable estimates for areas with sparse data. The aim was to reduce the noise in the disease maps to highlight the true underlying mortality distribution. Lung cancer in men showed strong spatial structure with a marked east-west gradient, but no appreciable urban-rural differences. In contrast, high mortality areas for female lung cancer were observed around conurbations. Female breast cancer and STS appeared to be spread uniformly across the region. Pleural cancer mortality clusters were evident around areas with major asbestos manufacturers, or natural asbestiform fibre pollution. Maps of Bayesian-estimated mortality risk provided appreciably clearer pictures of risk distribution than did maps of the standardized mortality ratio.

• Survival of malignant pleural mesothelioma cases in the Tuscan Mesothelioma Register, 1988-2000: a population-based study. G. Gorini, G. De Gregorio, S. Silvestri, et al. 2005;14(3):195-9. PubMed · Publisher

  Abstract

  This study analyses survival of Tuscan residents (Italy, 3.5 million population) diagnosed by histological examination with malignant pleural mesothelioma (MPM) during the period 1988-2000, and recorded in the Tuscan Malignant Mesothelioma Register. The aim was to establish the prognostic role of demographic, diagnostic and asbestos exposure variables. During 1988-2000, 381 MPM cases were recorded (318 men; 63 women). Vital status was ascertained up to 31 December 2002. No cases were lost to follow-up. Median survival of certain MPM was 324 days (11 months; 95% CI 297-366); 45.7% (95% CI 40.6-50.6%) survived more than 1 year; 24.2% (95% CI 20.0-28.5%) more than 2 years. In univariate and multivariate analyses survival was associated with histological subtype (epithelioid subtype had the longest survival). Gender, age, period of diagnosis, hospital of diagnosis and asbestos exposure did not show significant effects. Therapeutic information was available for patients of the period 1997-2000. There was no significant difference in survival between treated versus untreated patients. In conclusion, no advance in prognosis at the population level in the most recent period can be suggested on the basis of the data available to the Tuscan Malignant Mesothelioma Register.

• Incidence of digestive cancers and occupational exposure to asbestos. S. de La Provôté, N. Desoubeaux, C. Paris, et al. 2002;11(6):523-8. PubMed · Publisher

  Abstract

  While the role of exposure to asbestos in the development of several cancers such as mesotheliomas and bronchopulmonary cancers is now well established, the possible relationship between digestive cancers, other than peritoneal mesotheliomas, and occupational exposure to asbestos is still controversial. The great majority of the studies are based on mortality data. The aim of the study was to analyse the relationship between digestive cancer incidence and occupational exposure to asbestos in a population of subjects for whom precise occupational exposure data and precise incidence data were available. The population consisted of salaried and retired workers from a company using asbestos to manufacture fireproof textiles and friction materials. There were 1454 men (79.9%) and 366 women (20.1%). A cumulative exposure index and a mean exposure concentration in fibres/ml for each subject were calculated with the aid of an in-house job-exposure matrix. The number of cases of digestive cancer observed was compared with the expected and Standardized Incidence Ratio (SIR) was estimated. Precise occupational exposure data allowed us to study the dose-response relationship between asbestos exposure and risk of digestive cancer using Cox model. Fifty-six digestive cancers occurred in the study population over the 18-year follow-up period for 48.4 expected (SIR = 1.16 [0.87-1.50]). Comparing with incidence in the county, SIR was not significant for any of the digestive localization, but for peritoneum. However, even after taking into account the potential confounders via the Cox model, there was a significant dose-response relationship between the occurrence of digestive cancers and the mean exposure concentration, even after exclusion of peritoneum cancers. Our study provides initial evidence suggesting a relationship between occupational exposure to asbestos and the risk of digestive cancer: first, it is a study of incidence although the risk evidenced is not significant; secondly, a dose-effect relationship is demonstrated in the whole population. However, these preliminary results require confirmation by more powerful studies focusing on larger series.

• An age, period and cohort analysis of pleural cancer mortality in Europe. C. La Vecchia, A. Decarli, J. Peto, et al. 2000;9(3):179-84. PubMed

  Abstract

  Death certification data from pleural cancer in eight European countries providing data to the World Health Organization database over the period 1970-1994 were analysed using a log-linear Poisson model to disentangle the effects of age, birth cohort and period of death. The age effect reached values between 10 and 15/100,000 males at age 80-84 in most countries, except Hungary (6.7), Switzerland (18.0), France (20.6) and the Netherlands (36.5). Cohort effects were steadily and appreciably upwards in all countries up to the generations born in 1940 or 1945, and levelled off for the 1950 cohort, except in Hungary, where persistent rises were observed. Thus, most rises in pleural cancer mortality in Europe were on a cohort of birth basis. Since most pleural cases were asbestos-related mesotheliomas, and since asbestos has an early-stage effect on subsequent mesothelioma risk, exposure early in life is important for determining the subsequent mesothelioma risk of each generation. Consequently, the data indicate that the peak mortality from pleural cancer in most western European countries will be reached in the first decades of the 21st century, i.e. around 2010-2020, when the generations born between 1940 and 1950 will reach the peak age for mesothelioma incidence and mortality. This contrasts with US data, where the peak of pleural cancer incidence has been reached at the end of the 20th century, and reflects a delay in adopting adequate prevention measures since the 1940-1945 generations entered the workforce in the 1960s, when cancer risk from asbestos exposure was already recognized.

1990s

• Increased but low incidence and poor survival of malignant mesothelioma in the southeastern part of The Netherlands since 1970: a population-based study. M.L. Janssen-Heijnen, R.A. Damhuis, P.J. Klinkhamer, et al. 1999;8(4):311-4. PubMed · Publisher

  Abstract

  Changes in the incidence and survival rates for malignant mesothelioma in the southeastern part of The Netherlands since 1970 were investigated, using data from the Eindhoven Cancer Registry (ECR). The exposure to asbestos in this area is presumed to be limited. Most of the mesotheliomas occurred in the pleura, where there were 119 (88%) against 15 (11%) in the peritoneum and two in the tunica vaginalis testis. Compared to other European countries, the incidence rate for the southeastern part of The Netherlands was fairly low in the second half of the 1980s. Between 1975 and 1994 the age-adjusted incidence rates (ESR) for pleural mesothelioma increased twofold (from 10 to 19 per one million person-years among men and from 2.4 to 3.8 among women). The rate for peritoneal mesothelioma remained constant. The overall relative 0.5-, 1-, and 3-year survival rates remained 68, 42, and 8%, respectively. The fourfold higher incidence rate for men compared with women reflects the fact that mesothelioma is mainly an occupational disease. In view of presumed limited exposure to asbestos and small geographical variation, the incidence of mesothelioma in the southeastern part of The Netherlands will probably remain low, despite an increase in the past decades.

• Asbestos-related familial mesothelioma. C. Bianchi, A. Brollo, C. Zuch. 1993;2(3):247-50. PubMed · Publisher

  Abstract

  Familial mesotheliomas are reported in four pairs of patients. The group includes six men and two women, aged between 44 and 84 years. A blood relation (father-son) existed in two pairs only. All the present patients had histories of exposure to asbestos; in five cases exposure had occurred in the shipyards. Familial mesothelioma could represent a useful model for investigating genetic-environmental interactions.

• Biomarker assessments in asbestos-exposed workers as indicators for selective prevention of mesothelioma or bronchogenic carcinoma: rationale and practical implementations. E. Pluygers, P. Baldewyns, P. Minette, et al. 1992;1(2):129-38. PubMed · Publisher

  Abstract

  In the first part of this study we have shown how the serum levels of four selected tumour markers, namely tissue polypeptide antigen (TPA), carcino-embryonic antigen (CEA), hyaluronic acid (HA) and ferritin, display patterns characteristic of mesothelioma (M) or bronchogenic carcinoma (BC) in asbestos-exposed workers, and we hypothesize that the differences in marker patterns correspond to differences in carcinogenesis mechanisms. In a preliminary study, we found these specific marker patterns in 5/19 exposed workers of whom only one demonstrated any radiological signs of disease. Thus these specific marker patterns may be early events, occurring long (possibly years) before the classical radiological signs of exposure to asbestos. Accordingly they afford an optimal opportunity for prevention which should be adapted to the carcinogenesis mechanism as it is revealed by the marker pattern; it is aimed at antagonizing free radical carcinogenesis in all persons with TPA levels in excess of 100 U/l or Ferritin in excess of 400 ng/ml, and at inhibiting chemical carcinogenesis in those having elevated CEA levels (over 3 ng/ml). The mechanisms involved in these inhibitory processes are described and discussed, as well as the practical implementations that proceed from them. A prevention trial is now being started among 300 active and retired workers of an asbestos-cement works in northern France; the design of the study is presented. This prevention programme should be maintained over many years and holds a strong potential for reducing the untoward effects of exposure to asbestos.

• Biomarker assessments in asbestos-exposed workers as indicators for selective prevention of mesothelioma or bronchogenic carcinoma: rationale and practical implementations. E. Pluygers, P. Baldewyns, P. Minette, et al. 1991;1(1):57-68. PubMed · Publisher

  Abstract

  Asbestos-associated malignancies are one of the major industrial hazards of recent decades and will continue to be so until beyond the end of the century. It has been estimated that, in the United States alone, there will be 131,200 cancer deaths as a result of asbestos exposure. At present the early lesions are detected radiologically, by which time intervention is no longer effective. The aim of this study was to test the value of a battery of serum biomarkers in the early detection of malignancy and in distinguishing between the early stages of mesothelioma and bronchogenic carcinoma. Many of the biomarkers had no discriminating value but on the basis of four such markers (namely TPA, CEA, HA and ferritin) it has been possible to distinguish between the late stages of the two malignancies and asbestosis. The results are discussed in terms of their possible application to the detection of early pre-malignant lesions in a screened population of asbestos-exposed persons, with the aim of attempting to prevent cancer death in such early detected cases.

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