Laryngeal cancer and asbestos

Our plain-English summary of Laryngeal cancer and asbestos, by G. Hillerdal, C.E. Lindholm (ORL; Journal for Oto-rhino-laryngology and Its Related Specialties, 1980).

The study

• Authors: G. Hillerdal, C.E. Lindholm
• Journal: ORL; Journal for Oto-rhino-laryngology and Its Related Specialties
• Published: 1980;42(4):233-41
• Cited by: 13 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. 000810).

Abstract

A 10-year material of laryngeal carcinomas was studied retrospectively. The chest X-rays were examined for pleural plaques (PP), which are a reliable sign of earlier asbestos exposure. In 14 of 156 available chest X-rays typical PP were found; a significantly higher incidence that expected in the region (p less than 0.001), but in agreement with earlier studies, which are reviewed. It is suggested that all patients with laryngeal carcinoma should be questioned about exposure to asbestos, and that in patients occupationally exposed to asbestos, the occurrence of laryngeal carcinoma should be considered an occupational disease.

In plain English

This retrospective study, from Uppsala University Hospital in Sweden, looked at patients newly diagnosed with laryngeal (voice box) cancer between 1968 and 1977. The authors checked chest X-rays for pleural plaques, scars on the lining of the lungs that they describe as a reliable sign of earlier asbestos exposure. Of 179 men, 156 had usable X-rays, and 14 (9%) showed typical plaques on both sides. This was compared with 1.62% among men over 40 in an earlier X-ray survey from the same county, a difference the authors reported as significant (p less than 0.001). Of 20 women, 17 had X-rays and one had plaques. She denied any asbestos exposure. Of 142 men with known smoking histories, 138 were smokers or ex-smokers, and all 13 men with plaques and a known smoking history were current smokers. Job histories were too sporadic to draw conclusions. The patients also came from a wider area than the comparison survey. The authors concluded that asbestos exposure combined with smoking gives rise to more laryngeal cancer. They also concluded that in asbestos-exposed patients it can be regarded as an occupational disease.

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: Retrospective hospital case series: chest X-rays of laryngeal cancer patients reviewed for pleural plaques and compared with an expected rate from an earlier county X-ray survey
• Who was studied: Patients with newly diagnosed undifferentiated or squamous cell laryngeal carcinoma treated at the University Hospital, Uppsala, Sweden, 1968 to 1977: 179 men (156 with acceptable chest X-rays) and 20 women (17 with chest X-rays)
• Exposure: Earlier asbestos exposure, judged indirectly by the presence of pleural plaques on chest X-ray. No fiber types, products or doses were measured. Smoking and drinking habits and occupation were taken from case histories.
• Main results:
  • Men: acceptable chest X-rays were available for 156 of 179. Of these, 14 (9%) showed typical bilateral pleural plaques.
  • The rate in men was significantly higher than the comparison figure of 1.62% from an earlier county study (p less than 0.001). That earlier figure applied to men above 40 years.
  • Men: of 142 with a known smoking history, 138 (97.2%) were smokers or ex-smokers.
  • Men: of 94 asked about drinking, 92 (97.9%) reported alcohol consumption.
  • Men with pleural plaques: all 13 who gave a smoking history were current smokers.
  • Women: 17 of 20 had chest X-rays, and one had typical widespread, extensively calcified pleural plaques. She was a heavy smoker and denied all exposure to asbestos.
  • Women: smoking habits were known for 13, of whom 8 were current or former smokers.
• The authors' conclusion: The authors concluded that asbestos exposure in association with smoking gives rise to a higher incidence of laryngeal carcinoma. They also concluded that asbestos-exposed patients with laryngeal carcinoma can be regarded as having an occupational disease, while tobacco remains the most important cause.
• Limitations the authors state:
  • Occupational histories were sporadic, so no significant conclusions about occupation could be drawn. The authors noted only a trend toward more manual and industrial workers.
  • Patients came from a wider region than the county used for the expected rate, so the plaque rate there might differ. The authors considered this unlikely.

Topics

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

Medical terms in this study, explained in our Lexicon: Laryngeal Cancer, Carcinoma, Chest X-Ray, Pleural Plaques, Asbestos Exposure, Occupational Disease.

Related studies

• The epidemiology of laryngeal cancer in Brazil — V. Wünsch Filho (2004)
• Asbestos fibers in laryngeal tissues. Findings in two patients with asbestosis associated with laryngeal tumors — A. Hirsch, J. Bignon, et al. (1979)
• Current theories for the development of nonsmoking and nondrinking laryngeal carcinoma — R. Wight, V. Paleri, et al. (2003)
• Asbestosis, laryngeal carcinoma, and malignant peritoneal mesothelioma in an insulation worker — A. Fischbein, J.C. Luo, et al. (1991)
• Exposure to asbestos and laryngeal carcinoma — P.M. Stell, T. McGill (1975)
• Diet and other risk factors for laryngeal cancer in Shanghai, China — W. Zheng, W.J. Blot, et al. (1992)

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