Silicosis, asbestosis, and cancer of the lung

Our plain-English summary of Silicosis, asbestosis, and cancer of the lung, by W.C. Hueper (American Journal of Clinical Pathology, 1955).

The study

• Author: W.C. Hueper
• Journal: American Journal of Clinical Pathology
• Published: 1955;25(12):1388-90
• Cited by: 7 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. 001863).

Summary of the article

This editorial reviewed published evidence on whether dust-related lung diseases are linked to lung cancer. For silica, the author cited data indicating that lung cancer was not excessively frequent among coal and silica-exposed workers. Merewether found carcinoma of the lung at postmortem in 99 of 6884 silicosis cases (1.32 per cent), and Sporlein found lung cancer in 7 of 383 autopsied men with silicosis (1.8 per cent) against an expected 9.9 to 12 per cent. Sporlein suggested a possible antagonism between the two conditions. For asbestosis, the author described the evidence for a causal relationship with lung cancer as quite substantial. He counted 127 recorded cases (United States 21, Canada 6, Great Britain 88, Germany 12), including 10 among 21 autopsied asbestos textile plant employees in a Pennsylvania community. Lung cancer frequency in asbestosis autopsy series ranged from 7.5 to 50 per cent, and was 15.5 per cent across 738 collected autopsies. Among 56 cases, 29 were squamous cell, 15 round cell-anaplastic, 7 adenocarcinomas and 5 mixed. Tumors often involved the lower lobes. Exposure periods ranged from 6 months to 42 years, and the lag after exposure ended could be as long as 20 years. The author concluded that the evidence was adequate to recognize asbestosis cancer of the lung as an occupational disease for medicolegal purposes. He noted possible 'neighborhood' cases near asbestos plants. He stated that the increased risk appeared limited to people with asbestosis.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This 1955 editorial reviewed reports on whether dust-related lung diseases raise lung cancer risk. It was not an original study, but it included O'Donnell's unpublished, personally communicated findings: 10 lung cancers among 21 asbestosis autopsies in employees of a Pennsylvania asbestos textile plant. For silicosis, the author cited reports of few lung cancers; in one autopsy series, 7 of 383 men with silicosis (1.8 per cent) had lung cancer against an expected 9.9 to 12 per cent. For asbestosis, the author counted 127 recorded cases of lung cancer with asbestosis. In 738 asbestosis autopsies collected from the literature, 114 had lung cancer (15.5 per cent); individual series ranged from 7.5 to 50 per cent. The tumors described were of varied cell types, often in the lower lobes, after exposure periods of 6 months to 42 years. The author judged the evidence adequate for medicolegal recognition of asbestosis lung cancer as an occupational disease. The author raised the possibility of cases among people who had lived near asbestos plants, and stated that the increased risk appeared limited to people with asbestosis.

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: Editorial reviewing published literature and reported case series, with some unpublished autopsy findings supplied by personal communication (no original study by the author)
• Who was studied: Recorded cases of lung cancer with asbestosis (127 cases from the United States, Canada, Great Britain and Germany), autopsy series of asbestosis, including O'Donnell's unpublished series of 21 asbestosis autopsies from a small Pennsylvania community, and, for comparison, published autopsy series of silicosis
• Exposure: Asbestos, described as a magnesium-iron silicate mined in North America and South Africa (no specific fiber types named); silica and coal dust discussed for comparison
• Main results:
  • In a cited autopsy series (Sporlein) of 383 men with silicosis aged 47 to 75, lung cancer was found in 7 (1.8 per cent), against an expected 9.9 to 12 per cent
  • Merewether, as cited, reported carcinoma of the lungs at postmortem in 99 of 6884 cases of silicosis (1.32 per cent)
  • In autopsy series of asbestosis collected from the literature, lung cancer was found in 114 of 738 autopsies (15.5 per cent as printed); individual series ranged from 7.5 to 50 per cent
  • O'Donnell (personal communication, not a published report) observed 10 of the American cases among 21 autopsy cases of asbestosis seen 1940 to 1954 in a small Pennsylvania community, in employees of an asbestos textile plant
  • Among 56 asbestosis lung cancers, 29 were squamous cell type and 15 round cell-anaplastic, with the rest adenocarcinomas or mixed forms
  • The tumors often involved the lower lobes (four-fifths, according to Isselbacher, Klaus, and Hardy)
  • Exposure to asbestos preceding and accompanying asbestosis and lung cancer ranged from 6 months to 42 years
  • Merewether, as cited, gave a male-female ratio for asbestosis lung cancer of 2.45:1
  • The author raised the possibility that asbestosis could be found at autopsy in people with no asbestos job history because they had lived near an asbestos plant
  • The author stated that the epidemiologic data then available indicated the increased lung cancer risk was limited to people with asbestosis, not to asbestos exposure without that disease
• The authors' conclusion: The author concluded that the available scientific evidence was adequate to recognize lung cancer with asbestosis as an occupational disease for medicolegal purposes
• Limitations the authors state:
  • The author stated it was uncertain whether a minimum dust level (170,000 particles per liter of air) or a minimum particle size is needed for asbestosis lung cancer to develop
  • The author noted that asbestosis lung cancers had not been reliably produced in experimental animals

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer.

Medical terms in this study, explained in our Lexicon: Silicosis, Lung Cancer, Carcinoma, Autopsy, Squamous Cell Carcinoma, Adenocarcinoma, Occupational Disease.

Related studies

• Mixed pneumoconiosis: silicosis, asbestosis, talcosis, and berylliosis — G.J. Mark, C.B. Monroe, et al. (1979)
• Silicosis and asbestosis: diagnosis, prevention and treatment — O.A. Sander (1955)
• Cancer incidence and mortality among Finnish asbestos sprayers and in asbestosis and silicosis patients — P. Oksa, E. Pukkala, et al. (1997)
• Serum oncoproteins and growth factors in asbestosis and silicosis patients — P.W. Brandt-Rauf, S. Smith, et al. (1992)
• Mechanisms in the pathogenesis of asbestosis and silicosis — B.T. Mossman, A. Churg (1998)
• Asbestosis and silicosis — G.R. Wagner (1997)

Browse more research in American Journal of Clinical Pathology, or return to medical research.