Occupational asbestos exposure and the incidence of non-Hodgkin lymphoma of the gastrointestinal tract: an ecologic study

Our plain-English summary of Occupational asbestos exposure and the incidence of non-Hodgkin lymphoma of the gastrointestinal tract: an ecologic study, by M.M. Treggiari, N.S. Weiss (Annals of Epidemiology, 2004).

The study

• Authors: M.M. Treggiari, N.S. Weiss
• Journal: Annals of Epidemiology
• Published: 2004;14(3):168-71
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: A previous case-control study observed a strong association between occupational exposure to asbestos and the incidence of non-Hodgkin lymphoma of the gastrointestinal tract (GINHL). To test this hypothesis, we sought to determine whether the geographic pattern of the incidence of GINHL in the US has paralleled that of mesothelioma.

Methods: Using data obtained from the nine US regions participating in the National Cancer Institute's Surveillance, Epidemiology and End Results program, we examined the incidence of malignancies among men ages 50 to 84 years between 1973 and 1984.

Results: The rates of mesothelioma, but not of GINHL, were about two times higher in the areas of Seattle and San Francisco, than in the other regions. Overall, there was no correlation between the rates of mesothelioma and of GIHNL (Pearson correlation coefficient-0.12, p = 0.77).

Conclusions: This ecologic study finds no support for the hypothesis that occupational asbestos exposure is related to the subsequent incidence of GINHL.

In plain English

This ecologic study tested an earlier Los Angeles case-control finding linking work exposure to asbestos with non-Hodgkin lymphoma of the gastrointestinal tract. The authors did not measure exposure; they used mesothelioma rates as a marker of how common asbestos exposure was in an area. Using registry data from nine US regions in the National Cancer Institute's SEER program, they compared the two cancers' rates among men aged 50 to 84, 1973 to 1984. Mesothelioma rates in Seattle (Puget Sound) and San Francisco–Oakland combined were 6.80 per 100,000 person-years (95% CI 5.41 to 8.18), against 3.32 (2.66 to 3.99) in all other regions. Lymphoma rates (gastrointestinal tract and oral cavity) were 3.35 (2.89 to 3.81) and 3.76 (3.31 to 4.21) for the same groupings. They found no correlation between the two cancers' rates (p-value 0.77). They concluded that the study gave no support for the hypothesis. They added that mesothelioma differed between regions by at most two-fold, so this is not particularly strong evidence against it. They had limited ability to account for other risk factors.

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: Ecologic study comparing regional incidence rates from cancer registries
• Who was studied: Men aged 50 to 84 in the nine US regions covered by the SEER cancer registries (New Mexico, Connecticut, Hawaii, Utah, Iowa, Seattle-Tacoma, San Francisco–Oakland, Detroit, Atlanta), 1973 to 1984
• Exposure: Occupational asbestos exposure was not measured directly. Regional mesothelioma incidence was used as a stand-in for how common asbestos exposure was. No fiber types are named.
• Main results:
  • Mesothelioma rates were highest in Seattle (Puget Sound), at 7.93 per 100,000 person-years (95% CI 6.30, 9.56), and San Francisco–Oakland, at 5.95 (95% CI 4.51, 7.39). The two areas combined had 6.80 (95% CI 5.41, 8.18), against 3.32 (95% CI 2.66, 3.99) in all other regions (men aged 50 to 84).
  • Rates of non-Hodgkin lymphoma of the gastrointestinal tract and oral cavity were 3.35 per 100,000 person-years (95% CI 2.89, 3.81) in Seattle/San Francisco–Oakland combined and 3.76 (95% CI 3.31, 4.21) in all other regions. Rates were very slightly lower in Seattle and San Francisco–Oakland overall and for the oral cavity, stomach and intestine separately.
  • There was no correlation between mesothelioma rates and gastrointestinal non-Hodgkin lymphoma rates across the regions: Pearson correlation coefficient 0.12, p 0.77. The sign of the coefficient is lost in the text.
  • In a sub-analysis not restricted to men aged 50 and above, there was a similar lack of association: Pearson correlation coefficient 0.04, p 0.913.
• The authors' conclusion: The authors concluded that the study finds no support for the hypothesis that occupational asbestos exposure is related to gastrointestinal non-Hodgkin lymphoma. They also said this should not be read as particularly strong evidence against that hypothesis, and that cohort or case-control data would be desirable.
• Limitations the authors state:
  • Mesothelioma incidence differed at most two-fold between high- and low-risk regions. This means the difference in asbestos exposure between regions was smaller than would be ideal for an ecologic analysis.
  • The authors had limited ability to account for other risk factors for gastrointestinal lymphoma. They could only adjust for age, study men, and restrict the calendar period to reduce HIV-related cases.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Case-Control Study, Occupational Exposure, Mesothelioma, Epidemiology.

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