Lung Cancer Cell Type and Asbestos Exposure

Abstract

It is often claimed that adenocarcinoma is the most frequent type of lung cancer seen in workers exposed to asbestos. Careful review of the published data, however, fails to support this claim. Rather, it seems that all types of lung cancers occur in asbestos workers, and the presence or absence of a specific cell type cannot be used to prove or disprove an association of carcinoma and asbestos exposure.

Worldwide trends in lung cancer pathology

“…However, occupational protection from asbestos exposure is not as rigorous in many other counties, and exportation of industries with high asbestos exposure to Asian, African and South American countries will likely result in a new wave of asbestos‐related lung cancers and mesotheliomas in these areas of the world 21,22 . Although mesothelioma is a form of thoracic cancer that is specifically linked to asbestos, asbestos exposure does not appear to preferentially drive the development of any particular histological pattern of bronchogenic cancer 23 . However, it is possible that any effects of asbestos in causing a specific phenotype of bronchogenic cancer could easily be masked by the effects of cigarette smoking, which is highly prevalent among asbestos‐exposed individuals.…”

“…21,22 Although mesothelioma is a form of thoracic cancer that is specifically linked to asbestos, asbestos exposure does not appear to preferentially drive the development of any particular histological pattern of bronchogenic cancer. 23 However, it is possible that any effects of asbestos in causing a specific phenotype of bronchogenic cancer could easily be masked by the effects of cigarette smoking, which is highly prevalent among asbestos-exposed individuals.…”

Occupational, environmental and iatrogenic lung disease

“…The increased risk involves carcinomas of all the histological types encountered in the lung, although adenocarcinoma has been disproportionately overrepresented. 245,[280][281][282][283][284][285] It is uncertain 114 whether the increased risk of carcinoma is caused by the asbestos 192,[286][287][288][289][290][291] or the asbestosis. [292][293][294][295][296][297][298][299] The latter view envisages the carcinoma arising in the foci of alveolar epithelial hyperplasia and dysplasia that commonly accompany any interstitial fibrosis (see carcinoma complicating idiopathic pulmonary fibrosis, p. 275).…”

“…7.1.26). 238,245,[281][282][283][284][285] The majority view has been that asbestosis is a necessary precursor of the carcinoma but evidence to the contrary is finding increasing support (Table 7.1.8). 192 In the UK, industrial compensation was formerly only awarded to an asbestos worker for carcinoma of the lung if there was also asbestosis or diffuse pleural fibrosis but new rules were introduced in 2006.…”

The molecular epidemiology of asbestos and tobacco in lung cancer

“…Many studies have supported this general mechanism, reporting an increased proportion of lower lobe tumors among asbestos exposed populations (Craighead and Mossman, 1982;Jacob and Anspach, 1965;Kannerstein and Churg, 1972;Soutar et al, 1974;Talcott and Antman, 1988;Weiss, 1988a;Whitwell et al, 1974), as well as an increased proportion of adenocarcinomas in asbestos exposed lung cancer patients (Auerbach et al, 1979;Browne, 1986;Hourihane and McCaughey, 1966;Husgafvel-Pursiainen et al, 1999;Johansson and Albin, 1992;Karjalainen, 1994;Mollo et al, 1995;Raffin et al, 1993;Talcott and Albin, 1988;Whitwell et al, 1974). However, these associations have not been reported by all studies (Auerbach et al, 1984;Brodkin et al, 1997;Churg, 1985;deKlerk et al, 1996;Hillerdal et al, 1983;Huuskonen, 1978;Kannerstein and Churg, 1972;Lee et al, 1998;Vainio and Boffetta, 1994), and as the proportion of adenocarcinoma and lower lobe tumors have steadily increased among non-asbestos exposed populations (i.e. women and former smokers) the implications of these patterns have become less clear.…”