Asbestos-related lung cancer: Clinical characteristics and survival outcomes in an Australian cohort seeking workers compensation

Asia Pac J Clin Oncol. 2022 Oct;18(5):e448-e455. doi: 10.1111/ajco.13664. Epub 2022 Jan 31.

Abstract

Background and objectives: Due to difficulties in identifying sufficient-sized cohorts there remains uncertainty about prognostic and clinical differences that may be unique to asbestos-related lung cancer (ARLC). In this study, we use the Helsinki Criteria to define a group of ex-workers with lung cancer attributable to asbestos exposure and investigate differences that may exist.

Methods: A total of 529 patients seeking workers' compensation for their lung cancer were assigned to either ARLC or the non-ARLC based on parameters defined in the Helsinki Criteria. Clinical and survival details were collected and analyzed.

Results: In our study population, ARLC patients were on average older (72.1 ± 7.8) than non-ARLC patients (66.5 ± 10.2, P < 0.001) and were more likely to be diagnosed as a result of incidental findings or screening program (P < 0.001). The groups were similar in terms of clinical characteristics with the only difference being that plaques were more prevalent among ARLC patients (P < 0.001). Differences were observed for median overall survival (OS), ARLC (9 months) and non-ARLC (13 months, P = 0.005), as well for treatment (P = 0.01). After adjusting for age, however, these differences disappeared.

Conclusions: Age at diagnosis, pleural plaques, and asymptomatic presentation were the attributes that we identified as significantly different between asbestos-related cancer and other lung cancers. In this cohort, ARLC patients were older diagnosis and with worse overall survival.

Keywords: asbestos; cancer risk factors; carcinogenesis; clinical epidemiology; lung cancer.

MeSH terms

  • Asbestos* / analysis
  • Asbestos* / toxicity
  • Australia
  • Humans
  • Lung Neoplasms* / epidemiology
  • Lung Neoplasms* / etiology
  • Mesothelioma*
  • Occupational Exposure* / adverse effects
  • Workers' Compensation

Substances

  • Asbestos