Epidemiology

BJC Open article

British Journal of Cancer (2012) 106, 575–584. doi:10.1038/bjc.2011.563 www.bjcancer.com
Published online 10 January 2012

There is a Corrigendum (9 December 2014) associated with this article.

Estimating the asbestos-related lung cancer burden from mesothelioma mortality

V McCormack1, J Peto2, G Byrnes3, K Straif4 and P Boffetta5,6

  1. 1Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France
  2. 2Faculty of Epidemiology and Population Health, Department of Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
  3. 3Biostatistics Group, Section of Genetics, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France
  4. 4Section of IARC Monographs, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France
  5. 5Institute for Translational Epidemiology and Tisch Cancer Institute, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574, USA
  6. 6International Prevention Research Institute, Lyon, France

Correspondence: Dr P Boffetta, E-mail: paolo.boffetta@mssm.edu

Received 13 September 2011; Revised 21 November 2011; Accepted 23 November 2011
Advance online publication 10 January 2012

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Abstract

Background:

  

Quantifying the asbestos-related lung cancer burden is difficult in the presence of this disease's multiple causes. We explore two methods to estimate this burden using mesothelioma deaths as a proxy for asbestos exposure.

Methods:

  

From the follow-up of 55 asbestos cohorts, we estimated ratios of (i) absolute number of asbestos-related lung cancers to mesothelioma deaths; (ii) excess lung cancer relative risk (%) to mesothelioma mortality per 1000 non-asbestos-related deaths.

Results:

  

Ratios varied by asbestos type; there were a mean 0.7 (95% confidence interval 0.5, 1.0) asbestos-related lung cancers per mesothelioma death in crocidolite cohorts (n=6 estimates), 6.1 (3.6, 10.5) in chrysotile (n=16), 4.0 (2.8, 5.9) in amosite (n=4) and 1.9 (1.4, 2.6) in mixed asbestos fibre cohorts (n=31). In a population with 2 mesothelioma deaths per 1000 deaths at ages 40–84 years (e.g., US men), the estimated lung cancer population attributable fraction due to mixed asbestos was estimated to be 4.0%.

Conclusion:

  

All types of asbestos fibres kill at least twice as many people through lung cancer than through mesothelioma, except for crocidolite. For chrysotile, widely consumed today, asbestos-related lung cancers cannot be robustly estimated from few mesothelioma deaths and the latter cannot be used to infer no excess risk of lung or other cancers.

Keywords:

asbestos; lung cancer; mesothelioma; chrysotile