title: Esophagus cancer and occupational exposure to asbestos: results from a meta-analysis of epidemiology studies.
abstract: The relationship between occupational asbestos exposure and esophagus cancer (EC) is not fully understood. We performed a meta-analysis to quantitatively assess the association. We systematically searched databases of PubMed, EMBASE, and Web of Science for studies with quantitative estimates of asbestos exposure and EC mortality. Pooled standardized mortality ratios (SMRs) and their corresponding 95% confidence intervals (CIs) were calculated. Twenty cohort studies on EC and asbestos exposure were included in this meta-analysis. Overall, occupational exposure to asbestos was associated with an excess risk of EC (SMR = 1.24, 95% CI: 1.13-1.38, P < 0.001), with little evidence of heterogeneity among studies (I(2) = 0.0%, P = 0.682). Being male, exposure to chrysotile or mixed asbestos, working at textile industry, long study follow-up (≥20 years), Asia, Europe and America cohorts with larger cohort size (>500), and high-exposure group all contribute to significantly higher SMR. Publication bias was not detected (Egger's test P-value = 0.374). This meta-analysis suggested that occupational asbestos exposure might be associated with an increased risk of EC in male. High-exposure level of asbestos could contribute to significantly higher risk of EC mortality.
authors.affiliation: Preventive Care, Gumei Community Health Service Center, Shanghai, Minhang District, China.
authors.forename: B
authors.initials: B
authors.lastname: Li
authors.affiliation: Prevention branch of key infectious diseases, Bozhou Center for Disease Control and Prevention, Bozhou, Anhui, China.
authors.forename: S P
authors.initials: SP
authors.lastname: Tang
authors.affiliation: Preventive Care, Gumei Community Health Service Center, Shanghai, Minhang District, China.
authors.forename: K Z
authors.initials: KZ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000209:etiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
chemical_list: D001194:Asbestos
keywords: SMR; asbestos; esophagus cancer; meta-analysis