title: Occupational asbestos exposure and digestive cancers - a cohort study.
abstract: BACKGROUND
  Although the role of asbestos in the genesis of mesothelioma and primary bronchopulmonary cancers has been established, results from studies focusing on the relationship between occupational exposure to asbestos and digestive cancer remain contradictory.
  
  
  OBJECTIVE
  To determine whether occupational asbestos exposure increases the incidence of digestive cancers.
  
  
  METHODS
  Our study was a retrospective morbidity study based on 2024 subjects occupationally exposed to asbestos. The incidence of digestive cancer was calculated from 1st January 1978 to 31st December 2004 and compared with levels among the local general population using Standardized Incidence Ratios. Asbestos exposure was assessed using the company's job exposure matrix.
  
  
  RESULTS
  Eighty-five cases of digestive cancer were observed within our cohort, for an expected number of 66.90 (SIR = 1.27 [1.01; 1.57]). A significantly elevated incidence, particularly notable among women, was observed for peritoneal mesothelioma, independently of exposure levels. A significantly elevated incidence was also noted among men for cancer of small intestine and oesophagus, for cumulative exposure indexes for asbestos above 80 fibres/mL x years. A significantly elevated incidence of cancer of the small intestine was also observed among men having been exposed to asbestos for periods in excess of 25 years and for mean exposure levels in excess of 4 fibres/mL.
  
  
  CONCLUSIONS
  This study suggests the existence of a relationship between exposure to asbestos and cancer of the small intestine and of the oesophagus in men.
authors.affiliation: Cancers and populations, ERI3 INSERM, Faculty of Medicine, Caen University Hospital, Caen, France. clin-b@chu-caen.fr
authors.forename: B
authors.initials: B
authors.lastname: Clin
authors.forename: F
authors.initials: F
authors.lastname: Morlais
authors.forename: B
authors.initials: B
authors.lastname: Dubois
authors.forename: A-V
authors.initials: AV
authors.lastname: Guizard
authors.forename: N
authors.initials: N
authors.lastname: Desoubeaux
authors.forename: M-F
authors.initials: MF
authors.lastname: Marquignon
authors.forename: C
authors.initials: C
authors.lastname: Raffaelli
authors.forename: C
authors.initials: C
authors.lastname: Paris
authors.forename: F
authors.initials: F
authors.lastname: Galateau-Salle
authors.forename: G
authors.initials: G
authors.lastname: Launoy
authors.forename: M
authors.initials: M
authors.lastname: Letourneux
mesh_terms: D001194:Asbestos / Q000009:adverse effects*; D015331:Cohort Studies; D004067:Digestive System Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D009017:Morbidity; D016273:Occupational Exposure / Q000009:adverse effects*; D012189:Retrospective Studies; D013223:Statistics as Topic; D013997:Time Factors
chemical_list: D001194:Asbestos