Relationship between exposure to ionizing radiation and mesothelioma risk: A systematic review of the scientific literature and meta‐analysis

Abstract

Malignant mesothelioma is an infrequent neoplasm that usually arises from the lining cells of the pleural and peritoneal cavities. According to the evidence, asbestos is the most significant risk factor of mesothelioma 1,2 ; the cumulative lifetime risk of developing the disease in the absence of exposure to asbestos, has been estimated to be approximately 3 in 10,000. 3 Recent epidemiological studies have focused on additional possible causal factors of mesothelioma, including asbestiform mineral fibers (erionite; fluoroadenine); carbon nanotubes; chronic serous inflammation; and ionizing radiation. 4

Clinical significance of 9P21 gene combined with BAP1 and MTAP protein expression in diagnosis and prognosis of mesothelioma serous effusion

“…Malignant mesothelioma (MM) is a highly aggressive tumor originating from serous mesothelioma cells (1), which is characterized by cryptic onset, difficult diagnosis, advanced stage upon discovery and short survival period. In recent years, the number of individuals exposed to asbestos chemical materials has increased, and the prevalence of malignant mesothelioma is increasing year by year.…”

Re: Comment to “Relationship between exposure to ionizing radiation and mesothelioma risk: A systematic review of the scientific literature and meta‐analysis”

“…In conclusion, the inclusion of the sixth cohort of workers exposed to ionizing radiation did not modify our previous conclusion that these workers experienced an increased risk of mesothelioma. 1 However, the fact that in the additional cohort the increased risk was restricted to workers with concomitant potential exposure to asbestos, and not among workers exposed to ionizing radiation but not to asbestos (IR employed outside NPP or shipyard), suggests caution in attributing the excess risk of mesothelioma to occupational exposure to ionizing radiation.…”

“…After the publication of our meta‐analysis entitled, “Relationship between exposure to ionizing radiation and mesothelioma risk: A systematic review of the scientific literature and meta‐analysis”, 1 we have become aware of an additional study that reported results on mesothelioma mortality among workers exposed to ionizing radiation.…”

“…When we repeated the meta-analysis including this additional cohort using the methodology described in our recent report, 1 we calculated a pooled relative risk (RR) of 4.43 (95% CI 2.77-7.09; Figure 1), compared to a pooled RR of 3.57 (95% CI 2.16-5.89) reported in our study. 1 In conclusion, the inclusion of the sixth cohort of workers exposed to ionizing radiation did not modify our previous conclusion that these workers experienced an increased risk of mesothelioma.…”

“…When we repeated the meta-analysis including this additional cohort using the methodology described in our recent report, 1 we calculated a pooled relative risk (RR) of 4.43 (95% CI 2.77-7.09; Figure 1), compared to a pooled RR of 3.57 (95% CI 2.16-5.89) reported in our study. 1 In conclusion, the inclusion of the sixth cohort of workers exposed to ionizing radiation did not modify our previous conclusion that these workers experienced an increased risk of mesothelioma. 1 However, the fact that in the additional cohort the increased risk was restricted to workers with concomitant potential exposure to asbestos, and not among workers exposed to ionizing radiation but not to asbestos (IR employed outside NPP or shipyard), suggests caution in attributing the excess risk of mesothelioma to occupational exposure to ionizing radiation.…”