title: Estimating the asbestos-related lung cancer burden from mesothelioma mortality.
abstract: BACKGROUND
  Quantifying the asbestos-related lung cancer burden is difficult in the presence of this disease's multiple causes. We explore two methods to estimate this burden using mesothelioma deaths as a proxy for asbestos exposure.
  
  
  METHODS
  From the follow-up of 55 asbestos cohorts, we estimated ratios of (i) absolute number of asbestos-related lung cancers to mesothelioma deaths; (ii) excess lung cancer relative risk (%) to mesothelioma mortality per 1000 non-asbestos-related deaths.
  
  
  RESULTS
  Ratios varied by asbestos type; there were a mean 0.7 (95% confidence interval 0.5, 1.0) asbestos-related lung cancers per mesothelioma death in crocidolite cohorts (n=6 estimates), 6.1 (3.6, 10.5) in chrysotile (n=16), 4.0 (2.8, 5.9) in amosite (n=4) and 1.9 (1.4, 2.6) in mixed asbestos fibre cohorts (n=31). In a population with 2 mesothelioma deaths per 1000 deaths at ages 40-84 years (e.g., US men), the estimated lung cancer population attributable fraction due to mixed asbestos was estimated to be 4.0%.
  
  
  CONCLUSIONS
  All types of asbestos fibres kill at least twice as many people through lung cancer than through mesothelioma, except for crocidolite. For chrysotile, widely consumed today, asbestos-related lung cancers cannot be robustly estimated from few mesothelioma deaths and the latter cannot be used to infer no excess risk of lung or other cancers.
authors.affiliation: Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France.
authors.forename: V
authors.initials: V
authors.lastname: McCormack
authors.forename: J
authors.initials: J
authors.lastname: Peto
authors.forename: G
authors.initials: G
authors.lastname: Byrnes
authors.forename: K
authors.initials: K
authors.lastname: Straif
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
mesh_terms: D001194:Asbestos / Q000633:toxicity*; D002273:Carcinogens / Q000633:toxicity*; D015331:Cohort Studies; D014943:Global Health; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000401:mortality* / Q000473:pathology; D008654:Mesothelioma / Q000139:chemically induced / Q000401:mortality* / Q000473:pathology; D008954:Models, Biological; D009026:Mortality; D047368:Tumor Burden; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D002273:Carcinogens; D001194:Asbestos