Asbestos-Related lung Cancer: An underappreciated oncological issue
Nico van Zandwijk, Arthur L. Frank, Glen Reid, Oluf Dimitri Røe, Christopher I. Amos
Abstract
Asbestos, a group of class I (WHO) carcinogenic fibers, is the main cause of mesothelioma. Asbestos inhalation also increases the risk to develop other solid tumours with lung cancer as the most prominent example [91Zona A. Fazzo L. Benedetti M. Bruno C. Vecchi S. Pasetto R. Di Fonzo D. SENTIERI-Epidemiological study of residents in National Priority Contaminated Sites. Sixth report.Epidemiol. Prev. 2023; 47: 1-286https://doi.org/10.19191/EP23.1-2-S1.003Crossref PubMed Scopus (0) Google Scholar]. The incidence of asbestos-related lung cancer (ARLC) is estimated to be to six times larger than the mesothelioma incidence thereby becoming an important health issue [86Villeneuve P.J. Parent M.E. Harris S.A. Johnson K.C. Canadian Canc R. Occupational exposure to asbestos and lung cancer in men: evidence from a population-based case-control study in eight Canadian provinces.BMC Cancer. 2012; 12595https://doi.org/10.1186/1471-2407-12-595Crossref PubMed Scopus (33) Google Scholar]. Although the pivotal role of asbestos in inducing lung cancer is well established, the precise causal relationships between exposures to asbestos, tobacco smoke, radon and ‘particulate’ (PM2.5) air pollution remain obscure and new knowledge is needed to establish appropriate preventive measures and to tailor existing screening practices[22Finnish Institute of Occupational Health. (2014). Asbestos, asbestosis, and cancer: Helsinki criteria for diagnosis and attribution 2014. https://www.ttl.fi/sites/default/files/2023-04/asbestos-asbestosis-and-cancer-book.pdf.Google Scholar, 61Raffn E. Lynge E. Juel K. Korsgaard B. Incidence of cancer and mortality among employees in the asbestos cement industry in Denmark.Occupational and Environmental Medicine. 1989; 46: 90-96https://doi.org/10.1136/oem.46.2.90Crossref Scopus (100) Google Scholar, 65Røe O.D. Stella G.M. Malignant pleural mesothelioma: history, controversy, and future of a man-made epidemic.Asbestos and Mesothelioma. 2017; 73–101https://doi.org/10.1183/09059180.00007014Crossref Scopus (137) Google Scholar]. We hypothesize that a part of the increasing numbers of lung cancer diagnoses in never-smokers can be explained by (historic and current) exposures to asbestos as well as combinations of different forms of air pollution (PM2.5, asbestos and silica).