Occupational and nonoccupational factors associated with high grade bronchial pre-invasive lesions.
Besides tobacco exposure, factors associated with the development of pre-invasive bronchial lesions are not known. Autofluorescence bronchoscopy was used to assess the prevalence of severe dysplasia and carcinoma in situ (SD/CIS) of the proximal bronchial tree in relation to occupational or nonoccupational carcinogen exposure. Among the 241 individuals in this study, the overall prevalence of at least one SD/CIS was 9% (21 subjects). Multivariable analysis revealed significant and independent associations between presence of SD/CIS and: 1) active smoking, relative to former smokers; 2) presence of synchronous invasive lung cancer; 3) duration of asbestos exposure and; 4) exposure to other occupational carcinogens. The independent associations of synchronous lung cancer with severe dysplasia and carcinoma, after adjusting for both occupational and nonoccupational carcinogen exposures, suggest other mechanisms than a field cancerisation may be involved in the carcinogenesis of these pre-invasive lesions. Moreover, active smokers, patients with recently resected invasive lung cancer and workers occupationally exposed to bronchial carcinogens may represent a population of choice for early cancer endoscopic detection programmes in view of their high severe dysplasia and carcinoma prevalence.
Paris
C
C
Dept of Occupational Diseases, Rouen University Hospital, Rouen, France. christophe.paris@chu-rouen.fr
Benichou
J
J
Bota
S
S
Sagnier
S
S
Metayer
J
J
Eloy
S
S
Auliac
J B
JB
Nouvet
G
G
Thiberville
L
L
D001194:Asbestos / Q000009:adverse effects; D001982:Bronchial Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D001984:Bronchial Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D001999:Bronchoscopy; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D005260:Female; D005453:Fluorescence; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D001194:Asbestos