Magnitude of asbestos-related lung cancer mortality in Italy

Our plain-English summary of Magnitude of asbestos-related lung cancer mortality in Italy, by A. Marinaccio, A. Scarselli, A. Binazzi, et al (British Journal of Cancer, 2008).

The study

• Authors: A. Marinaccio, A. Scarselli, A. Binazzi, M. Mastrantonio, P. Ferrante, S. Iavicoli
• Journal: British Journal of Cancer
• Published: 2008;99(1):173-5
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

An ecological study, based on a data set containing all lung and pleural cancer deaths in each Italian municipality in the period 1980-2001, was performed. The pleural to lung cancer ratio was estimated to be 1 : 1 and 3% (around 700) of all male lung cancer deaths were found to be asbestos-related.

In plain English

This short communication reported an ecological study of males in all 8101 Italian municipalities from 1980 to 2001. The authors used each municipality's pleural cancer death rate as a marker of past asbestos exposure. They then estimated how many lung cancer deaths were asbestos-related, taking into account altitude, urbanisation and a deprivation (poverty) index. Over the period, 536 538 lung cancer deaths and 12 216 pleural cancer deaths were recorded among Italian males. Across municipalities, lung cancer and pleural cancer death rates showed a direct, statistically significant correlation (Pearson's r = 0.15, P less than 0.001). Depending on the statistical model, asbestos-related lung cancer deaths were estimated at 1.6 to 3.7% of all male lung cancer deaths, or 380 to 770 deaths per year. That works out to between 0.68 and 1.37 asbestos-related lung cancer deaths for each mesothelioma death. The authors judged a ratio of 1:1 between pleural cancer deaths and asbestos-related lung cancer deaths, with 3% of male lung cancer deaths (around 700 per year) asbestos-related, as the most reliable estimate. They described compensation figures for 2000 to 2004 as an underestimate of around four-fold compared with these findings.

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: Ecological study (short communication) using municipal mortality data and multiple regression models
• Who was studied: Male population of all 8101 Italian municipalities, 1980 to 2001: 536 538 lung cancer deaths and 12 216 pleural cancer deaths
• Exposure: Past asbestos exposure, not measured directly. Municipal pleural cancer mortality was used as a proxy for past exposure in each area.
• Main results:
  • Across all Italian municipalities, lung cancer and pleural cancer standardised death rates among males were directly and significantly correlated (Pearson's r = 0.15, P less than 0.001)
  • Across the models, estimated asbestos-related lung cancer deaths in Italian males were 1.6 to 3.7% of all lung cancer deaths, or between 380 and 770 deaths per year
  • The models estimated between 0.68 and 1.37 asbestos-related lung cancer deaths for each mesothelioma death in Italy. The ratio compared pleural cancer deaths with estimated asbestos-related lung cancer deaths, not with all lung cancer deaths.
  • Model 4 had the best fit but was judged not adequate, because urbanisation and deprivation were strongly correlated. Models 2 or 3 were considered most reliable.
  • Among municipalities with at least 10 pleural cancer deaths, Casale Monferrato, Broni and Monfalcone had the highest pleural cancer rates (38.9, 29.5 and 22.3 per 100 000, respectively)
  • In 2000 to 2004, compensation was given in 2370 asbestos-related mesothelioma cases and 913 asbestos-related lung cancer cases (means of 474 and 183 per year). The authors described this as an underestimate of around four-fold compared with their epidemiological findings.
• The authors' conclusion: The authors considered the most reliable predictions to be a 1:1 ratio of pleural cancer deaths to asbestos-related lung cancer deaths, with 3% of all male lung cancer deaths asbestos-related, averaging around 700 asbestos-related lung cancers per year among males in Italy

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.

Related studies

• Burden of Mortality from Asbestos-Related Diseases in Italy — L. Fazzo, A. Binazzi, et al. (2021)
• Asbestos related diseases in Italy: an integrated approach to identify unexpected professional or environmental exposure risks at municipal level — A. Marinaccio, A. Scarselli, et al. (2008)
• Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy — F. Luberto, D. Ferrante, et al. (2019)
• Asbestos-related lung cancer mortality in Piedmont, Italy — M. Martuzzi, P. Comba, et al. (1998)
• Ophiolitic outcrops, naturally occurring asbestos exposure and mortality risk from malignant mesothelioma in Calabria (Southern Italy) — A. Scarselli, A. Marinaccio, et al. (2021)
• Mortality for Mesothelioma and Lung Cancer in a Cohort of Asbestos Cement Workers in BARI (Italy): Time Related Aspects of Exposure — F. Cuccaro, A.M. Nannavecchia, et al. (2019)

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