Incidence of cancer among Finnish patients with asbestos-related pulmonary or pleural fibrosis.
OBJECTIVE
To study the asbestos-associated risk of lung cancer according to the histological type of cancer, the time of and time since diagnosis of asbestosis, the asbestos-associated risk for cancers other than lung cancer or mesothelioma, and the predictive value of asbestos-related pleural abnormalities as regards the risk of cancer.


METHODS
Finnish patients with asbestosis (n = 1,376) or asbestos-related benign pleural disease (n = 4,887) notified as an occupational disease since 1964 were followed-up through the Finnish Cancer Registry for cancer in 1967-95.


RESULTS
Compared with the total cancer incidence in Finland, men with asbestosis had a raised risk of lung cancer (standardized incidence ratio [SIR] = 6.7; 95% confidence interval [CI] = 5.6-7.9), mesothelioma (SIR = 32, CI = 14-60) and cancer of the larynx (SIR = 4.2, CI = 1.4-9.8). The risk of lung cancer was similarly raised for all histological types of lung cancer (the highest in insulators) and did not change markedly over time of notification or duration of follow-up. Men with benign pleural disease had a raised risk of mesothelioma (SIR = 5.5, CI = 1.5-14) and a slightly elevated risk of lung cancer (SIR = 1.3, CI = 1.0-1.8). Among women with asbestosis, significant excess was found for lung cancer and mesothelioma.


CONCLUSIONS
Asbestosis and asbestos-related benign pleural disease seem to possess different predictive values as regards the risk of lung cancer.
Karjalainen
A
A
Finnish Institute of Occupational Health, Department of Epidemiology and Biostatistics, Helsinki.
Pukkala
E
E
Kauppinen
T
T
Partanen
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects*; D001195:Asbestosis / Q000150:complications*; D002273:Carcinogens / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010994:Pleura / Q000473:pathology; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000150:complications*
D002273:Carcinogens; D001194:Asbestos