A meta-analysis of colorectal cancer and asbestos exposure

Am J Epidemiol. 1994 Jun 15;139(12):1210-22. doi: 10.1093/oxfordjournals.aje.a116967.

Abstract

A meta-analysis of the relation between asbestos exposure and colorectal cancer mortality was conducted, using published reports of 20 asbestos-exposed cohorts. Summary standardized mortality ratios (SMRs) for colorectal cancer were examined in relation to asbestos type and estimates of dust exposure (as direct estimators of asbestos exposure) and in relation to lung cancer SMR and the proportion of all deaths due to mesothelioma (as proxy estimators of asbestos exposure). An elevated summary SMR was observed in cohorts exposed to amphibole asbestos (summary SMR = 1.47; 95% confidence interval (CI) 1.09-2.00), but not in cohorts exposed to serpentine asbestos (summary SMR = 1.04; 95% CI 0.81-1.33) or in cohorts exposed to both serpentine and amphibole asbestos (summary SMR = 1.03; 95% CI 0.74-1.42). Cohorts having a lung cancer SMR greater than 2.00 had a summary SMR of 1.51 (95% CI 1.29-1.76), and cohorts in which more than 1% of all deaths were attributed to mesothelioma had a summary SMR of 1.24 (95% CI 0.94-1.64). After stratifying the cohorts based on mortality due to all cancers excluding those known or suspected to be associated with asbestos exposure, lung cancer mortality was not clearly associated with colorectal cancer mortality, suggesting that the crude association between these factors may be due to misdiagnosis of lung cancer as other types of cancer in the reported causes of death. These results suggest that exposure to amphibole asbestos may be associated with colorectal cancer, but these findings may reflect an artifact of miscertification of cause of death. The results also suggest that serpentine asbestos is not associated with colorectal cancer.

Publication types

  • Meta-Analysis
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Asbestos / adverse effects*
  • Asbestos / analysis
  • Cohort Studies
  • Colonic Neoplasms / chemically induced
  • Colonic Neoplasms / mortality*
  • Dust / analysis
  • Female
  • Humans
  • Lung Neoplasms / mortality
  • Male
  • Occupational Diseases / chemically induced
  • Occupational Diseases / mortality*
  • Occupational Exposure / adverse effects*
  • Occupational Exposure / analysis
  • Poisson Distribution
  • Rectal Neoplasms / chemically induced
  • Rectal Neoplasms / mortality*
  • Regression Analysis

Substances

  • Dust
  • Asbestos