Mesothelioma in blood related subjects: report of 11 clusters among 1954 Italy cases and review of the literature.
BACKGROUND
Malignant mesothelioma is a sporadic tumor related to asbestos. Its occurrence in blood relatives raises the question of potential contribution of predisposing factors.


METHODS
The study analyses the features of mesothelioma in blood relatives that might explain the disease clustering. Data sources of familial clusters were three population-based Mesothelioma Registries in Italy (Veneto and Apulia Regions, Brescia province; 1978-2005) and Medline, Toxline, and Oshline/Hseline databases for a review of the literature (1968-2006).


RESULTS
Eleven clusters (22 cases) were identified among 1954 Italy mesothelioma cases, and 51 clusters (120 cases) were extracted from 33 studies. The proportion of Italy familial cases was 1.4 per 100 mesothelioma cases; the ratio between the number of familial clusters and the number of non-familial mesothelioma cases was 1:148. The mesothelioma profile in consanguineous is the same as in non-consanguineous subjects (male prevalence; pleural site; age at diagnosis >50 years; asbestos exposure). Most clusters occurred in asbestos workers (shipyard, asbestos-cement production/processing, and insulation) and household-exposed blood relatives. Others were related to asbestos-cement factory pollution, asbestos-in-place, and handling asbestos-contaminated textiles. Two clusters were without any known exposure. Cancer family history revealed lung cancer cases in eight clusters.


CONCLUSIONS
Available data support asbestos exposure as the main risk factor in mesothelioma cases among blood relatives. Our finding of a low proportion of familial cases would not suggest the influence of a large genetic component for mesothelioma in blood relatives.
Ascoli
Valeria
V
Department of Experimental Medicine, University La Sapienza, Rome, Italy. valeria.ascoli@uniroma1.it
Cavone
Domenica
D
Merler
Enzo
E
Barbieri
Pietro Gino
PG
Romeo
Luciano
L
Nardi
Francesco
F
Musti
Marina
M
D000328:Adult; D000368:Aged; D001194:Asbestos / Q000633:toxicity*; D016000:Cluster Analysis; D004198:Disease Susceptibility; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008487:Medical History Taking; D008654:Mesothelioma / Q000453:epidemiology / Q000235:genetics*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors
D001194:Asbestos