The priority for recognizing asbestos as a multicentre carcinogen, and problems in categorizing asbestos tumours

Our plain-English summary of The priority for recognizing asbestos as a multicentre carcinogen, and problems in categorizing asbestos tumours, by M. Greenberg (The European Respiratory Journal, 1998).

The study

• Author: M. Greenberg
• Journal: The European Respiratory Journal
• Published: 1998;11(4):996
• Type of article: Comment, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor reporting no new data. An earlier letter had credited Weiss's 1953 paper with the first report of two primary respiratory cancers in one asbestos worker. The author argued that Weiss only expressed a belief that such pleural disease was multicentric, and that Nordmann seems to have been the first to consider asbestos a cause of cancer arising at several sites. The letter said Nordmann found carcinomas in both lower lobe bronchi of one asbestos worker at autopsy, and later found areas of hyperplasia, metaplasia and carcinoma coexisting at various sites in individual mice. The author argued that lung cancer studies based on compensated cases will omit cases where asbestosis was judged absent. The letter also said that labeling mesothelioma as pleural or peritoneal at death registration is arbitrary when tumour appears above and below the diaphragm. The author cited an earlier register study of 246 malignant mesothelioma cases in which three had additional primary cancers. That was not significantly different from the 1.2% rate in a separate review of 3,771 general autopsies.

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: Letter to the editor (correspondence) giving historical and methodological commentary; no new study
• Who was studied: No population was studied; the letter discusses earlier publications on asbestos workers and mesothelioma cases
• Exposure: Asbestos exposure in asbestos workers in general; no specific fiber type is named
• Main results:
  • The author argued that Nordmann, not Weiss, appears to have been the first to consider asbestos a cause of cancer arising at multiple sites in asbestos workers
  • According to the letter, Nordmann (1938) found carcinomas in both right and left lower lobe bronchi at autopsy of one asbestos worker and judged them to have separate origins rather than to be spread from one tumour
  • According to the letter, a later Nordmann experiment found areas of hyperplasia, metaplasia and carcinoma coexisting at various sites in individual mice exposed to asbestos
  • The author argued that lung cancer mortality studies based on compensated cases (citing Berry, 1981) will leave out cases where asbestosis was judged not to be present
  • The author stated that when mesothelioma is found both above and below the diaphragm, recording it as pleural or peritoneal at death registration is arbitrary
  • In an earlier mesothelioma register study cited by the author (Greenberg and Lloyd Davies, 1974), three of 246 malignant mesothelioma cases had additional primary cancers
  • The letter says this was not significantly different from a separate review of 3,771 general autopsies (Cameron and colleagues, 1961), in which multiple primary cancers were found in 1.2%
• The authors' conclusion: The author concluded that these considerations, together with autopsy observations, call for a cautious approach to statistical analyses of cancer deaths in asbestos workers. The author suggested the rate of additional primary cancers might be larger in a carefully standardized prospective study.
• Limitations the authors state:
  • The author described the cited 246-case mesothelioma study as limited, because its autopsies were not standardized and were done by many pathologists

Topics

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

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