Non-asbestos-related malignant mesothelioma. A review

Our plain-English summary of Non-asbestos-related malignant mesothelioma. A review, by J.T. Peterson, S.D. Greenberg, P.A. Buffler (Cancer, 1984).

The study

• Authors: J.T. Peterson, S.D. Greenberg, P.A. Buffler
• Journal: Cancer
• Published: 1984;54(5):951-60
• Type of article: Review
• Cited by: 194 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. 000565).

Abstract

Malignant mesothelioma is an uncommon, but increasingly important, neoplasm. The existing English-language medical literature concerning non-asbestos-related malignant mesotheliomas was reviewed for evidence of other agents associated with the induction of malignant mesothelioma. Both animal and human data were reviewed. In most reviews of malignant mesothelioma, there are a significant proportion of cases without documented asbestos exposure (range, 0% to 87%). Furthermore, there are several fairly well-documented agents other than asbestos that induce malignant mesothelioma in animals, and strong evidence exists that such is the case in man. In reviews of malignant mesothelioma, the percentage of cases with asbestos exposure varies, but a significant number are apparently not asbestos related. It is believed that sufficient evidence exists to suggest that non-asbestos agents can induce malignant mesotheliomas in man, and additional epidemiologic studies in this area are needed.

In plain English

This article was a review. The authors reviewed the English-language medical literature, animal and human, for agents other than asbestos associated with pleural and peritoneal malignant mesothelioma. They stated that asbestos exposures are causally associated with mesothelioma. They also noted that in most published case series a significant proportion of cases had no documented asbestos exposure (range, 0% to 87%). The reports reviewed covered radiation, nickel, silica, beryllium, zeolite fibers such as erionite, man-made fibers, organic chemicals, viruses, chronic inflammation, certain industries, co-carcinogens and heredity. Many human reports described single patients. Erionite was linked to mesothelioma outbreaks in Turkish villages, although other researchers also reported asbestos minerals there. The authors attributed varying estimates partly to diagnostic difficulty and inconsistent exposure histories. They said the relevance of animal studies to humans was still unclear. They concluded that the many apparently non-asbestos-related cases strongly suggest a possible role for other agents, and called for further epidemiologic study.

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 (animal experiments and human reports)
• Who was studied: Published English-language medical literature on non-asbestos-related malignant mesothelioma, including animal studies and human case reports and case series. No search dates or count of studies are given.
• Exposure: Agents other than asbestos reported in the literature: radiation (including thorium dioxide), nickel, silica, beryllium, zeolites (erionite), man-made and mineral fibers, organic chemicals, viruses, chronic inflammation, nonasbestos industrial settings, co-carcinogens, hereditary predisposition and cigarette smoking.
• Main results:
  • The authors stated that asbestos exposures are causally associated with malignant mesotheliomas.
  • Across published reviews of malignant mesothelioma, a significant proportion of cases had no documented asbestos exposure, ranging from 0% to 87%.
  • The authors described several fairly well-documented agents other than asbestos that induce malignant mesothelioma in animals.
  • Many human reports reviewed were single cases. One example is a man who developed malignant peritoneal mesothelioma 16 years after radiation therapy for a seminoma of the testis.
  • Investigators studying mesothelioma epidemics in villages in the Anatolian region of Turkey linked them to zeolite fibers.
  • The zeolite explanation was challenged by Rohl and associates, who reported several kinds of asbestos minerals as well as erionite in environmental samples from those villages.
  • In the reviews cited, cigarette smoking was not found to be a contributing factor in malignant mesothelioma.
  • Diagnostic difficulty was offered as one reason estimates vary. In a Canadian series, a review panel favored the mesothelioma diagnosis in 42 of 71 reported cases (59%).
• The authors' conclusion: The authors concluded that the large number of apparently non-asbestos-related malignant mesotheliomas in humans strongly suggests the possible importance of agents other than asbestos, and that further epidemiologic study is needed.
• Limitations the authors state:
  • Histopathologic diagnosis and reporting of mesothelioma in the existing studies was not uniform.
  • Reporting of occupational exposure to industrial and environmental agents was incomplete and inconsistent.
  • The relevance of animal studies to humans was still unclear.
  • Nomenclature for experimentally induced tumors varied between observers, making animal data hard to compare.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Neoplasm, Asbestos Exposure.

Related studies

• Malignant mesothelioma induced by asbestos and zeolite in the mouse peritoneal cavity — Y. Suzuki, N. Kohyama (1984)
• Animal models of malignant mesothelioma — A.B. Kane (2006)
• Review of occupational lung carcinogens — K. Steenland, D. Loomis, et al. (1996)
• Carcinogenesis and related cell and tissue responses to asbestos: a review — B.T. Mossman (1994)
• Asbestos-related x-ray changes in foundry workers — K.D. Rosenman, M.J. Reilly (1998)
• Variations in the carcinogenicity of tremolite dust samples of differing morphology — J.M. Davis, J. Addison, et al. (1991)

Browse more research in Cancer, or return to medical research.