Malignant mesothelioma diagnosed at a younger age is associated with heavier asbestos exposure.

Journal Article (Journal Article)

Asbestos exposure is the main etiology of malignant mesothelioma, but there are conflicting data on whether the intensity of exposure modulates the development of this disease. This study considered 594 patients with malignant mesothelioma for whom count data on asbestos bodies and fibers (per gram of wet lung tissue) were available. The relationships between age at diagnosis (a time-to-event outcome variable) and these two measures of internal asbestos exposure, along with other possible modulating factors (sex, tumor location, histological subtype and childhood exposure), were assessed on multivariable Cox proportional hazard models, stratifying by decade of birth year. For both measures of asbestos in lung tissue, younger age at diagnosis was associated with higher internal measures of exposure to asbestos. Stratified Cox analyses showed that for each doubling in asbestos body count patients were 1.07 times more likely to be diagnosed at a younger age [hazard ratio (HR) = 1.07; 95% confidence interval (CI), 1.04-1.09; P = 2.2 × 10-7] and for each doubling in asbestos fiber count patients were 1.13 times more likely to be diagnosed at a younger age (HR = 1.13; 95% CI, 1.09-1.17; P = 8.6 × 10-11). None of the other variables considered were associated with age at diagnosis. Our finding that tumors become clinically apparent at a younger age in heavily exposed subjects suggests that asbestos is involved not only in the malignant mesothelioma tumor initiation but, somehow, also in the progression of the disease.

Full Text

Duke Authors

Cited Authors

  • Dragani, TA; Colombo, F; Pavlisko, EN; Roggli, VL

Published Date

  • September 21, 2018

Published In

Volume / Issue

  • 39 / 9

Start / End Page

  • 1151 - 1156

PubMed ID

  • 29982378

Electronic International Standard Serial Number (EISSN)

  • 1460-2180

Digital Object Identifier (DOI)

  • 10.1093/carcin/bgy089


  • eng

Conference Location

  • England