Stomach cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies.
BACKGROUND
A recent Monographs Working Group of the International Agency for Research on Cancer concluded that there is limited evidence for a causal association between exposure to asbestos and stomach cancer.


METHODS
We performed a meta-analysis to quantitatively evaluate this association. Random effects models were used to summarise the relative risks across studies. Sources of heterogeneity were explored through subgroup analyses and meta-regression.


RESULTS
We identified 40 mortality cohort studies from 37 separate papers, and cancer incidence data were extracted for 15 separate cohorts from 14 papers. The overall meta-SMR for stomach cancer for total cohort was 1.15 (95% confidence interval 1.03-1.27), with heterogeneous results across studies. Statistically significant excesses were observed in North America and Australia but not in Europe, and for generic asbestos workers and insulators. Meta-SMRs were larger for cohorts reporting a SMR for lung cancer above 2 and cohort sizes below 1000.


CONCLUSIONS
Our results support the conclusion by IARC that exposure to asbestos is associated with a moderate increased risk of stomach cancer.
MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK.
L
L
Fortunato
MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK.
L
L
Rushton
D001194:Asbestos / Q000633:toxicity*; D001315:Australia; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology; D016273:Occupational Exposure; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology
D001194:Asbestos