Malignant tumors of the female reproductive system

Our plain-English summary of Malignant tumors of the female reproductive system, by E. Weiderpass, F. Labrèche (Safety and Health at Work, 2012).

The study

• Authors: E. Weiderpass, F. Labrèche
• Journal: Safety and Health at Work
• Published: 2012;3(3):166-80
• Cited by: 74 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

This review summarizes the epidemiology of cancer of the female reproductive system and associated lifestyle factors. It also assesses the available evidence for occupational factors associated with these cancers. Cervical, endometrial, and ovarian cancers are relatively common, and cause significant cancer morbidity and mortality worldwide, whereas vulvar, vaginal, fallopian tube cancers, and choriocarcinomas are very rare. As several lifestyle factors are known to play a major role in the etiology of these cancers, very few published studies have investigated possible relationships with occupational factors. Some occupational exposures have been associated with increased risks of these cancers, but apart from the available evidence on the relationships between asbestos fibers and ovarian cancer, and tetrachloroethylene and cervical cancer, the data is rather scarce. Given the multifactorial nature of cancers of the female reproductive system, it is of the utmost importance to conduct occupational studies that will gather detailed data on potential individual confounding factors, in particular reproductive history and other factors that influence the body's hormonal environment, together with information on socio-economic status and lifestyle factors, including physical activity from multiple sources. Studies on the mechanisms of carcinogenesis in the female reproductive organs are also needed in order to elucidate the possible role of chemical exposures in the development of these cancers.

In plain English

This article was a review, not a new study. The authors summarized what was known about cancers of the female reproductive system, including cervical, endometrial, ovarian, vulvar, vaginal and fallopian tube cancers and choriocarcinoma. To assess occupational risk factors, they searched the Medline and Embase databases for studies published between 1981 and 2011 and consulted the International Agency for Research on Cancer (IARC) monographs. They reported that IARC classifies asbestos as a Group 1 agent considered carcinogenic to the human ovary. That classification rested mainly on cohort studies of women who made gas masks during World War II and on studies suggesting asbestos can accumulate in the ovaries of occupationally exposed women. In one earlier study of two groups of United Kingdom gas mask workers, the risk of dying from ovarian cancer was 2.96 times that of non-exposed women in the area for women exposed to crocidolite and chrysotile, and 1.74 times for women exposed to chrysotile only. Other reviewed studies reported borderline or elevated risks. The authors concluded that, apart from asbestos and tetrachloroethylene (linked to cervical cancer), the evidence on workplace exposures was scarce.

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: Review of published literature (not an original study)
• Who was studied: Published peer-reviewed studies on occupational risk factors for cancers of the female reproductive system, 1981 to 2011, found through Medline and Embase searches, plus IARC monographs
• Exposure: Among several occupational exposures reviewed: asbestos, including crocidolite and chrysotile in World War II gas mask manufacture, and asbestos mining, milling, product manufacture and use
• Main results:
  • Asbestos is an IARC Group 1 agent considered carcinogenic to the human ovary
  • In an earlier UK study of two groups of gas mask workers, women exposed to crocidolite and chrysotile had a risk of dying from ovarian cancer 2.96 times that of non-exposed women in the area
  • In the same UK gas mask study, women exposed to chrysotile only had a risk 1.74 times that of non-exposed women in the area
  • A smaller cohort of other UK workers showed a borderline significant increased risk of dying from ovarian cancer of 1.8 (95% CI 0.9-3.3)
  • A Finnish study using census job titles and a job-exposure matrix for asbestos reported a borderline increased ovarian cancer risk of 1.3 (95% CI 0.9-1.8)
  • A Russian study reported elevated ovarian cancer mortality among bookbinders (SMR 2.9, 95% CI 1.5-5.0) who were exposed to asbestos-contaminated talc fillers in paper
  • Translocation of asbestos fibers to the ovaries has been demonstrated, and the authors presumed that mechanisms similar to those described in the lungs and pleura apply to the ovary
  • Occupational exposure to tetrachloroethylene has been classified as probably carcinogenic to the human cervix uteri (Group 2A)
• The authors' conclusion: The authors concluded that, apart from the evidence for asbestos fibers and tetrachloroethylene, data on occupational exposures and these cancers were rather scarce, and that occupational studies collecting detailed individual data on confounding factors were needed
• Limitations the authors state:
  • Many of the reviewed studies were Nordic record-linkage studies, whose risk estimates are likely to be diluted toward the null value
  • Most published studies on these cancers did not gather information on occupational history

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology, Ovarian Cancer, Etiology, Occupational Exposure, Confounding, Carcinogenesis.

Related studies

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