Mesothelioma risk factors

Prevention

Preventable cases of mesothelioma, UK

Asbestos

Mesothelioma cases linked to exposure to asbestos, UK

94% (97% in males and 83% in females) of mesothelioma cases each year in the UK are linked to major lifestyle and other risk factors. 

Mesothelioma risk is associated with a number of risk factors.[1,2]

Mesothelioma Risk Factors

Increases risk ('sufficient' or 'convincing' evidence)[1,3] May increase risk ('limited' or 'probable' evidence) Decreases risk ('sufficient' or 'convincing' evidence) May decrease risk ('limited' or 'probable' evidence)
  • Asbestos (all forms)
    • Actinolite
    • Amosite ('brown asbestos')
    • Anthophyllite
    • Chrysotile ('white asbestos')
    • Crocidolite ('blue asbestos')
    • Tremolite
  • Erionite
  • Painting

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-

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International Agency for Research on Cancer (IARC) classification. World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classification does not include testicular cancer because the evidence is very limited.

References

  1. IARC. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from :http://monographs.iarc.fr/ENG/Classification/index.php. Accessed December 2013.
  2. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR; 2007.
  3. IARC. A Review of Human Carcinogens: Arsenic, Metals, Fibres, and Dusts (100c). Asbestos (Chrysotile, Amosite, Crocidolite, Tremolite, Actinolite and Anthophyllite). IARC: Lyon; 2012.
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The International Agency for Research on Cancer (IARC) classifies all six known types of asbestos Open a glossary item as causes of mesothelioma (though chyrsotile is less potent than the other asbestos types for inducing mesothelioma).[1] Asbestos exposure causes around 97% of mesothelioma cases in men, and around 83% in women in Great Britain, it is estimated.[2]

Asbestos exposure typically occurs in the workplace. Before the use and supply of asbestos was fully banned in the UK in the late 1990s, most exposures occurred in asbestos mining and manufacturing, and industries where asbestos was heavily used (for example shipbuilding and construction); today, most exposures are likely to occur when asbestos already in place is disturbed (for example during building maintenance).[2] Less common sources of exposure include paraoccupational/household (asbestos fibres brought into the home by exposed workers e.g. on work clothing), domestic/neighbourhood (living near an asbestos mine or production facility, or asbestos materials in the home releasing fibres due to everyday disturbance), and environmental (naturally-occurring asbestos in soil).[3] Mesothelioma incidence today reflects asbestos exposure many years ago, because there is a prolonged latency period.[4-6]

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Occupational exposure is associated with a 14-fold increase in mesothelioma risk, a large British cohort study showed.[1] Age at first occupational asbestos exposure may modify the risk, however evidence on this remains unclear, a systematic review showed.[2]

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Paraoccupational/household asbestos exposure is associated with an increase in mesothelioma risk of between five- and eight-fold, meta-analyses have shown.[1,2] However a British case-control study reported a lesser effect, with risk doubled in paraoccupationally exposed people.[3] Age at paraoccupational/household asbestos exposure may modify the risk but evidence is unclear, a systematic review showed.[4]

References

  1. Goswami E, Craven V, Dahlstrom DL, et al. Domestic asbestos exposure: a review of epidemiologic and exposure data. Int J Environ Res Public Health 2013;10(11):5629-70.
  2. Bourdes V, Boffetta P, Pisani P. Environmental exposure to asbestos and risk of pleural mesothelioma: review and meta-analysis. Eur J Epidemiol 2000;16(5):411-7.
  3. Rake C, Gilham C, Hatch J, et al. Occupational, domestic and environmental mesothelioma risks in the British population: a case-control study. BJC 2009;100(7):1175-83.
  4. Kang D, Myung MS, Kim YK, et al. Systematic Review of the Effects of Asbestos Exposure on the Risk of Cancer between Children and Adults. Ann Occup Environ Med. 2013 Jul 8;25(1):10.
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Domestic/neighbourhood asbestos exposure is associated with a seven-fold increased mesothelioma risk, a meta-analysis showed.[1] However findings are heterogeneous between studies, and a British case-control study found no increased risk in people living within a mile of a potential source of environmental exposure, or in those living in buildings potentially containing asbestos.[2]

References

  1. Bourdes V, Boffetta P, Pisani P. Environmental exposure to asbestos and risk of pleural mesothelioma: review and meta-analysis. Eur J Epidemiol 2000;16(5):411-7.
  2. Rake C, Gilham C, Hatch J, et al. Occupational, domestic and environmental mesothelioma risks in the British population: a case-control study. BJC 2009;100(7):1175-83.
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The International Agency for Research on Cancer (IARC) classifies occupation as a painter as a cause of mesothelioma.[1] While the IARC classification does not attribute this to a specific exposure, painters may have encountered asbestos in paints themselves (until the 1990s some paints contained asbestos as a filler), or in work sites (building maintenance may disturb asbestos already in place).[2]

References

  1. IARC. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from :http://monographs.iarc.fr/ENG/Classification/index.php. Accessed December 2013.
  2. IARC. A Review of Human Carcinogens: Painting, firefighting and shiftwork (98). IARC: Lyon; 2010.
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The International Agency for Research on Cancer (IARC) classifies erionite, a mineral similar to asbestos, as a cause of mesothelioma.[1] Evidence comes almost exclusively from one region in Turkey, where erionite is used as a building material, and mesothelioma rates are extremely high.[2] Because erionite occurs elsewhere in the world (notably parts of the US) without similarly high mesothelioma rates, it has been argued that the situation in Turkey indicates genetic susceptibility to erionite-associated mesothelioma in this population,[3] however evidence for this is weak.[1]

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Ionising radiation may increase mesothelioma risk, although evidence is not consistent, perhaps due to changes in mesothelioma coding.[1] Mesothelioma risk is slightly increased following radiotherapy for some previous cancers including breast, prostate and Hodgkin lymphoma, cohort studies of survivors indicate.[2-5] Exposure to thorium dioxide (Thorotrast) is associated with increased risk though this chemical has not been commonly used since the 1950s.[1] Nuclear workers are not at increased mesothelioma risk, a meta-analysis showed.[6]

References

  1. Goodman JE, Nascarella MA, Valberg PA. Ionizing radiation: a risk factor for mesothelioma. Cancer Causes Control 2009;20(8):1237-54.
  2. Teta MJ, Lau E, Sceurman BK, et al. Therapeutic radiation for lymphoma: risk of malignant mesothelioma. Cancer 2007;109(7):1432-8.
  3. Deutsch M, Land SR, Begovic M, et al. An association between postoperative radiotherapy for primary breast cancer in 11 National Surgical Adjuvant Breast and Bowel Project (NSABP) studies and the subsequent appearance of pleural mesothelioma. Am J Clin Oncol 2007;30(3):294-6.
  4. De Bruin ML, Burgers JA, Baas P, et al. Malignant mesothelioma after radiation treatment for Hodgkin lymphoma. Blood 2009;113(16):3679-81.
  5. Farioli A, Violante FS, Mattioli S, et al. Risk of mesothelioma following external beam radiotherapy for prostate cancer: a cohort analysis of SEER database. Cancer Causes Control 2013;24(8):1535-45.
  6. Metz-Flamant C, Guseva Canu I, Laurier D. Malignant pleural mesothelioma risk among nuclear workers: a review. J Radiol Prot 2011;31(1):9-23.
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People who have been occupationally exposed to mineral (rock and glass) wools are not at increased mesothelioma risk, a meta-analysis showed.[1] Exposure to silica is also not associated with mesothelioma risk, according to a pooled case-control study in France.[2] However, exposure to mineral wool or silica in conjunction with asbestos exposure may increase mesothelioma risk more than exposure to asbestos alone.[2]

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It has not been convincingly demonstrated that simian virus 40 (SV40) is associated with mesothelioma risk, an The International Agency for Research on Cancer (IARC) review concluded.[1]

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