Chest CT Scan Screening for Lung Cancer in Asbestos Occupational Exposure

Ollier, Monique; Chamoux, A.; Naughton, Géraldine; Pereira, Bruno; Dutheil, Frédéric

doi:10.1378/chest.13-2181

Cited by 67 publications

(48 citation statements)

References 37 publications

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“…Seven LDCT screening programmes among asbestos exposed workers were summarised in a meta-analysis28 with an overall rate of lung cancer detection at baseline of 1.1%, similar to what we report here. The Asbestos Review Programme in Western Australia offered LDCT to workers who had a minimum of 3 months asbestos exposure.…”

Section: Discussionsupporting

confidence: 66%

Early detection of lung cancer in a population at high risk due to occupation and smoking

Welch

Dement

Cranford³

et al. 2018

Occup Environ Med

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ObjectiveThe US National Comprehensive Cancer Network (NCCN) recommends two pathways for eligibility for Early Lung Cancer Detection (ELCD) programmes. Option 2 includes individuals with occupational exposures to lung carcinogens, in combination with a lesser requirement on smoking. Our objective was to determine if this algorithm resulted in a similar prevalence of lung cancer as has been found using smoking risk alone, and if so to present an approach for lung cancer screening in high-risk worker populations.MethodsWe enrolled 1260 former workers meeting NCCN criteria, with modifications to account for occupational exposures in an ELCD programme.ResultsAt baseline, 1.6% had a lung cancer diagnosed, a rate similar to the National Lung Cancer Screening Trial (NLST). Among NLST participants, 59% were current smokers at the time of baseline scan or had quit smoking fewer than 15 years prior to baseline; all had a minimum of 30 pack-years of smoking. Among our population, only 24.5% were current smokers and 40.1% of our participants had smoked fewer than 30 pack-years; only 43.5% would meet entry criteria for the NLST. The most likely explanation for the high prevalence of screen-detected lung cancers in the face of a reduced risk from smoking is the addition of occupational risk factors for lung cancer.ConclusionOccupational exposures to lung carcinogens should be incorporated into criteria used for ELCD programmes, using the algorithm developed by NCCN or with an individualised risk assessment; current risk assessment tools can be modified to incorporate occupational risk.

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Section: Discussionsupporting

confidence: 66%

Early detection of lung cancer in a population at high risk due to occupation and smoking

Welch

Dement

Cranford³

et al. 2018

Occup Environ Med

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“…Statistical analysis was conducted using Comprehensive Meta-analysis software (version 2, Biostat Corporation) [20,21,22,23] and Stata software (version 13, StataCorp, College Station, US). Baseline characteristics were summarized for each study sample and reported as mean (standard-deviation) and number (%) for continuous and categorical variables respectively.…”

Section: Methodsmentioning

confidence: 99%

Oxidative and Anti-Oxidative Stress Markers in Chronic Glaucoma: A Systematic Review and Meta-Analysis

d'Azy¹,

Pereira²,

et al. 2016

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Chronic glaucoma is a multifactorial disease among which oxidative stress may play a major pathophysiological role. We conducted a systematic review and meta-analysis to evaluate the levels of oxidative and antioxidative stress markers in chronic glaucoma compared with a control group. The PubMed, Cochrane Library, Embase and Science Direct databases were searched for studies reporting oxidative and antioxidative stress markers in chronic glaucoma and in healthy controls using the following keywords: “oxidative stress” or “oxidant stress” or “nitrative stress” or “oxidative damage” or “nitrative damage” or “antioxidative stress” or “antioxidant stress” or “antinitrative stress” and “glaucoma”. We stratified our meta-analysis on the type of biomarkers, the type of glaucoma, and the origin of the sample (serum or aqueous humor). We included 22 case-control studies with a total of 2913 patients: 1614 with glaucoma and 1319 healthy controls. We included 12 studies in the meta-analysis on oxidative stress markers and 19 on antioxidative stress markers. We demonstrated an overall increase in oxidative stress markers in glaucoma (effect size = 1.64; 95%CI 1.20–2.09), ranging from an effect size of 1.29 in serum (95%CI 0.84–1.74) to 2.62 in aqueous humor (95%CI 1.60–3.65). Despite a decrease in antioxidative stress marker in serum (effect size = –0.41; 95%CI –0.72 to –0.11), some increased in aqueous humor (superoxide dismutase, effect size = 3.53; 95%CI 1.20–5.85 and glutathione peroxidase, effect size = 6.60; 95%CI 3.88–9.31). The differences in the serum levels of oxidative stress markers between glaucoma patients and controls were significantly higher in primary open angle glaucoma vs primary angle closed glaucoma (effect size = 12.7; 95%CI 8.78–16.6, P < 0.001), and higher in pseudo-exfoliative glaucoma vs primary angle closed glaucoma (effect size = 12.2; 95%CI 8.96–15.5, P < 0.001). In conclusion, oxidative stress increased in glaucoma, both in serum and aqueous humor. Malonyldialdehyde seemed the best biomarkers of oxidative stress in serum. The increase of some antioxidant markers could be a protective response of the eye against oxidative stress.

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“…In a more specific way, a metaanalysis of Ollier et al (36) evaluated seven lung screening studies in asbestos-exposed workers, and reported 49 lung tumours between 5,074 asymptomatic subjects, with a prevalence of 1.1%; 18 tumours (36.7%) were at stage I and underwent radical surgery. Authors conclusion was that LDCT screening in asbestos-exposed subjects could reduce mortality as observed in strong smokers, and should not be denied, especially in patients with both exposures.…”

Section: Discussionmentioning

confidence: 99%

“…These differences make it difficult to compare the results of the trials, although a recent meta-analysis (36) showed that lung cancer prevalence in asbestos-exposed workers screening is equivalent to that reported in strong smokers.…”

Section: Ldct Lung Cancer Screening In Asbestos-exposed Workersmentioning

confidence: 99%

Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?—a systematic review about the use of screening programs in a population of asbestos exposed workers

Falaschi¹,

Romei²,

Fiorini

et al. 2018

J. Thorac. Dis.

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Malignant pleural mesothelioma (MPM) in an uncommon neoplasia with high mortality rate, mostly related to professional asbestos exposure. Clinical manifestations are not specific so that diagnosis is performed at advanced stage and screening protocols are not feasible now. On the other hand, asbestosexposed workers have a high incidence of developing lung cancer. Low-dose computed tomography (LDCT) is a volumetric acquisition technique with high spatial resolution and a low dose exposure; it is used in many trials to detect lung tumours at an early stage in screening protocols, reducing mortality rate in smoker subjects. In recent papers, the possibly role of lung cancer screening was evaluated and recommended also in subjects exposed to asbestos. This article summarizes previous and present clinical trials validated for lung cancer screening, to discuss the possibility of early diagnosis or screening programs in a population of asbestos exposed workers by LDCT.

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Chest CT Scan Screening for Lung Cancer in Asbestos Occupational Exposure

Cited by 67 publications

References 37 publications

Early detection of lung cancer in a population at high risk due to occupation and smoking

Early detection of lung cancer in a population at high risk due to occupation and smoking

Oxidative and Anti-Oxidative Stress Markers in Chronic Glaucoma: A Systematic Review and Meta-Analysis

Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?—a systematic review about the use of screening programs in a population of asbestos exposed workers

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