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Asbestos: Selected Cancers
APPENDIX E
Case-Control Results Tables
TABLE E.1 Pharyngeal Cancer and Exposure to Asbestos—Case-Control Studies
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Berrino et al. 2003
100 male cases of hypopharyngeal cancer from six centers in Southern Europe, < 55 years old (adjusted for smoking and alcohol consumption)
Possible
na
1.8 (0.9-3.9)
Probable
na
1.8 (0.6-5.0)
(More detailed findings from combined analysis with 215 cases of laryngeal cancer on Table E.2)
Luce et al. 2000
5 hypopharyngeal cancer cases among residents of New Caledonia
Whitewash from tremolite asbestos
1
0.64 (0.01-6.68)
Marchand et al. 2000
206 hypopharyngeal cancer cases among male residents of six cities in France (adjusted for smoking and alcohol consumption)
Any exposure
161
1.80 (1.08-2.99)
Low cumulative exposure
52
1.92 (1.03-3.57)
Intermediate
52
1.40 (0.74-2.63)
High
57
2.14 (1.14-4.01)
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Asbestos: Selected Cancers
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Gustavsson et al. 1998
138 pharyngeal cancer cases among male residents of two regions in Sweden (adjusted for smoking and alcohol consumption)
Asbestos (low)
24
1.01 (0.57-1.80)
Asbestos (high)
22
1.08 (0.62-1.91)
Zheng et al. 1992b
115 male oral or pharyngeal cancer cases among residents of Shanghai, China Asbestos, occupational exposure
16
1.81 (0.91-3.60)a
Merletti et al. 1991
86 oral cavity or oropharynx (n = 12) cancer cases among male residents of Turin, Italy (adjusted for smoking and alcohol consumption)
Any exposure
45
1.1 (na)
Probable or definite
3
0.4 (na)
NOTES: CI = Confidence interval; na = not available; RR = relative risk. Data points included in meta-analyses are bolded.
* Full citations can be found in the reference list for Chapter 6.
aOR and 95% CI calculated with standard methods from observed numbers of exposed cases and controls in original paper.
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Asbestos: Selected Cancers
TABLE E.2 Laryngeal Cancer and Exposure to Asbestos—Case-Control Studies
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Berrino et al. 2003
213 male cases of endolaryngeal cancer from six centers in Southern Europe, < 55 years old
Possible
na
1.7 (1.0-3.0)
Probable
na
1.8 (0.8-4.0)
Combined analysis with 100 hypopharyngeal cancer cases
Asbestos (JEM-derived agent), any exposure
215
1.6 (1.0-2.5)
10+ years duration and 20+ years lag
121
1.4 (0.8-2.4)
Likelihood of exposure
Possible
175
1.7 (1.1-2.8)
Probable
40
1.9 (0.9-3.8)
Duration of exposure
< 10 years
na
1.3 (0.6-2.7)
10-19 years
na
1.4 (0.7-2.7)
≥ 20 years
na
1.7 (0.9-3.0)
p-trend > 0.05
Tertiles of weighted exposure
1
na
1.4 (0.8-2.3)
2
na
1.9 (1.2-3.2)
3
na
1.6 (1.0-2.6)
p-trend = 0.037
Dietz et al. 2003
257 laryngeal cancer cases among residents of Rhein-Neckar region, Germany Asbestos
59
1.3 (0.8-2.1)
Elci et al. 2002
940 laryngeal cancer cases among male residents of Istanbul, Turkey (smoking-adjusted)
Asbestos (JEM-derived agent)
150
1.0 (0.8-1.3)
Glottis
28
0.8 (0.5-1.2)
Supraglottis
71
1.0 (0.8-1.4)
Other laryngeal
51
1.2 (0.9-1.7)
Intensity of exposure
Low
45
0.9 (0.6-1.3)
Medium
93
1.2 (0.9-1.6)
High
12
0.6 (0.3-1.1)
Probability of exposure
Low
121
1.2 (0.9-1.5)
Medium
20
0.6 (0.4-1.1)
High
9
0.7 (0.3-1.5)
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Asbestos: Selected Cancers
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Luce et al. 2000
20 laryngeal cancer cases among male residents of New Caledonia (all smokers)
Whitewash from tremolite asbestos
3
0.72 (0.22-2.30)
Melanesians
2
0.71 (0.14-3.63)
Non-Melanesians
1
0.60 (0.07-5.22)
Marchand et al. 2000
296 laryngeal cancer cases among male residents of six cities in France (smoking-adjusted)
Any exposure
216
1.24 (0.83-1.90)
Low cumulative exposure
67
1.10 (0.66-1.82)
Intermediate
72
1.20 (0.73-1.99)
High
77
1.47 (0.87-2.46)
Supraglottic, any exposure
56
1.12 (0.61-2.05)
Low cumulative exposure
15
0.84 (0.38-1.84)
Intermediate
22
1.31 (0.62-2.76)
High
19
1.27 (0.58-2.78)
Glottic and subglottic, any exposure
75
1.15 (0.68-1.95)
Low cumulative exposure
27
1.19 (0.62-2.27)
Intermediate
21
0.90 (0.45-1.78)
High
27
1.44 (0.73-2.83)
Epilarynx, any exposure
77
1.77 (0.94-3.30)
Low cumulative exposure
22
1.45 (0.67-3.13)
Intermediate
25
1.69 (0.79-3.64)
High
30
2.22 (1.05-4.71)
De Stefani et al. 1998
112 laryngeal cancer cases among male residents of Montevideo, Uruguay (smoking-adjusted)
Asbestos (self-reported agent)
231.8 (0.9-3.2)
1-20 years
4
0.9 (0.3-2.7)
20+ years
19
2.4 (1.2-4.8)
Supraglottic
na
2.3 (0.9-5.7)
Glottic
na
2.9 (0.8-10.5)
Gustavsson et al. 1998
157 laryngeal cancer cases among male residents of two regions in Sweden
Asbestos (low)
28
1.21 (0.73-2.02)
Asbestos (high)
34
1.69 (1.05-2.74)
Quartile I
13
1.16 (1.02-1.32)
Quartile II
15
1.35 (1.04-1.74)
Quartile III
16
1.56 (1.06-2.30)
Quartile IV
18
1.82 (1.08-3.04)
p-trend = 0.02
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Asbestos: Selected Cancers
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Muscat and Wynder 1992
186 laryngeal cancer cases among white, male residents of New York, Illinois, Michigan, and Pennsylvania, US
Asbestos, any exposure
66
1.1 (0.7-1.9)
Glottis
40
1.3 (0.7-2.7)
Supraglottis
26
1.1 (0.5-2.6)
Wortley et al. 1992
235 laryngeal cancer cases among residents of western Washington state, US
Asbestos—peak
None
145
1.0
Low
3
1.2 (0.6-7.1)
Medium
57
1.3 (0.8-2.0)
High
30
1.1 (0.6-1.9)
Asbestos—duration
< 1 year
151
1.0
1-9
50
1.0 (0.5-2.1)
≥ 10
34
1.2 (0.6-2.3)
Asbestos—exposure scores
< 5
173
1.0
5-19
25
1.1 (0.6-2.1)
≥ 20
37
1.4 (0.7-2.5)
Zheng et al. 1992a
201 laryngeal cancer cases among residents of Shanghai, China (smoking-adjusted)
Asbestos, occupational exposure
26
2.0 (1.0-4.3)
Ahrens et al. 1991
85 laryngeal cancer cases among male residents of Bremen, Germany (smoking-adjusted)
Asbestos
na
1.1 (0.5-2.4)
Brown et al. 1988
180 laryngeal cancer cases among male residents along Gulf Coast of Texas (smoking-adjusted)
Asbestos
88
1.5 (1.0-2.2)
< 5 years
20
1.3 (0.7-2.6)
5-14
24
2.2 (1.1-4.3)
≥ 15
40
1.4 (0.8-2.4)
unknown
4
Zagraniski et al. 1986
92 laryngeal cancer cases among white, male residents of New Haven, CT (smoking-adjusted)
Asbestos workers (ever held occupation)
11
1.1 (0.4-2.9)
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Asbestos: Selected Cancers
Reference
Study Population
Exposed Cases
Estimated RR (95% CI)
Olsen and Sabroe 1984
276 male laryngeal cancer cases among residents of Denmark (smoking-adjusted) Asbestos
17
1.8 (1.0-3.4)
Burch et al. 1981
184 laryngeal cancer cases among male residents of southern Ontario, Canada (smoking-adjusted)
Self-reported asbestos exposure
36
1.6 (p = 0.069)
Occupational hygienist classified exposure
14
2.3 (p = 0.052)
Hinds et al. 1979
47 laryngeal cancer cases among male residents of three counties in WA; self-reported asbestos exposure
All subtypes
25
1.75 (p = 0.21)
Glottis
na
1.29 (p = 0.63)
Supraglottis
na
4.00 (p = 0.22)
Shettigara and Morgan 1975
43 laryngeal cancer cases among male hospital patients in Toronto, Canada Asbestos
10
∞ (0 exposed controls)
Stell and McGill 1973
100 laryngeal cancer cases among male hospital patients in Liverpool, UK Asbestos
31
14.53 (4.27-49.43)a
NOTES: CI = Confidence interval; na = not available; RR = relative risk. Data points included in meta-analyses are bolded.
* Full citations can be found in the reference list for Chapter 6.
aOR and 95% CI calculated with standard methods from observed numbers of exposed cases and controls in original paper.
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Asbestos: Selected Cancers
TABLE E.3 Esophageal Cancer and Exposure to Asbestos—Case-Control Studies
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Parent et al. 2000
99 esophageal cancer cases among male residents of Montreal, Canada; IH-derived agent: chrysotile asbestos (smoking-adjusted)
All subtypes
Any exposure
21
1.4 (0.8-2.4)
Nonsubstantial
19
1.4 (0.8-2.5)
Substantial
2
1.3 (0.3-6.2)
63 squamous-cell carcinomas
Any exposure
17
2.0 (1.1-3.8)
Nonsubstantial
16
2.1 (1.1-4.0)
Substantial
1
1.1 (0.1-9.7)
Gustavsson et al. 1998
122 esophageal cancer cases among male residents of two regions in Sweden; IH-derived agent (smoking-adjusted)
Asbestos (low)
22
1.21 (0.67-2.17)
Asbestos (high)
21
1.00 (0.54-1.82)
Hillerdal 1980
Gastrointestinal carcinoma cases among male residents of Uppsala county, Sweden (exposure = pleural plaques)
21 esophageal
1
2.86 (0.07-15.91)a
NOTES: CI = Confidence interval; na = not available; RR = relative risk. Data points included in meta-analyses are bolded.
* Full citations can be found in the reference list for Chapter 6.
aOR and 95% CI calculated with standard methods from observed and expected numbers presented in original paper.
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Asbestos: Selected Cancers
TABLE E.4 Stomach Cancer and Exposure to Asbestos—Case-Control Studies
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Krstev et al. 2005
443 stomach cases among residents of Warsaw, Poland
285 males, ever exposed
42
1.5 (0.9-2.4)
1-9 years
19
1.2 (0.6-2.3)
≥ 10 years
23
1.9 (0.9-3.8)
158 females, ever exposed
1
0.3 (0.03-3.0)
1-9 years
1
0.4 (0.0-6.0)
≥ 10 years
0
—
Ekstrom et al. 1999
565 gastric cancer cases among residents of Sweden
155
1.11 (0.87-1.42)
Parent et al. 1998
250 male gastric cancer cases among residents of Montreal, Canada
Chrysotile asbestos
Nonsubstantial
43
1.2 (0.8-1.7)
Substantial
4
0.7 (0.2-1.8)
Amphibole asbestos
Nonsubstantial
10
0.6 (0.3-1.2)
Substantial
3
1.9 (0.6-6.9)
Cocco et al. 1994
640 gastric cancer cases among male residents of Italy
Ever exposed
239
0.7 (0.5-1.1)
21+ years
na
1.4 (0.6-3.0)
Hillerdal 1980
Gastrointestinal carcinoma cases among male residents of Uppsala county, Sweden (exposure = pleural plaques)
148 stomach
6
2.40 (0.88-5.22)a
NOTES: CI = Confidence interval; na = not available; RR = relative risk. Data points included in meta-analyses are bolded.
* Full citations can be found in the reference list for Chapter 6.
a95% CI calculated with standard methods from observed and expected numbers presented in original paper.
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Asbestos: Selected Cancers
TABLE E.5 Colorectal Cancer and Exposure to Asbestos—Case-Control Studies
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Goldberg et al. 2001
497 colon cancer cases among male residents of Montreal, Canada; industrial-hygiene-derived agent
Adjusted for age and non-occupational factors
Nonsubstantial
60
0.9 (0.6-1.3)
Substantial
18
2.1 (1.1-4.0)
Further adjusted for occupational factors
Nonsubstantial
60
0.9 (0.6-1.3)
Substantial
18
1.8 (0.9-3.6)
Frequency
1-5%
21
0.9 (0.5-1.6)
6-30%
49
1.1 (0.7-1.5)
> 30%
8
1.5 (0.6-3.7)
Concentration
Low
40
0.9 (0.6-1.4)
Medium
32
1.2 (0.8-1.8)
High
6
1.4 (0.4-4.3)
Duration (10-year increment)
78
1.1 (0.9-1.2)
Dumas et al. 2000
257 rectal cancer cases among male residents of Montreal, Canada
Chrysotile, any
30
0.7 (0.5-1.0)
Substantial
3
0.5 (0.2-1.6)
Amphiboles, any
11
0.7 (0.3-1.2)
Substantial
2
1.5 (0.3-7.6)
Demers et al. 1994
261 colorectal cancer cases among white males residents of southeast Michigan
15
0.5 (0.3-1.0)
Duration (years)
< 20
9
0.6 (0.3-1.5)
20+
6
0.4 (0.1-1.2)
Latency (years)
< 40
5
0.4 (0.1-1.3)
40+
10
0.6 (0.2-1.4)
Vineis et al. 1993
74 colon cancer cases among male residents of industrialized northern Italy (job titles) Jobs with putative asbestos exposure
4
4.8 (1.05-21.5)
Garabrant et al. 1992
419 male colon cancer cases among residents of Los Angeles County, CA Never exposed
353
1.00
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Asbestos: Selected Cancers
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
No latency
Any exposure
66
0.99 (0.66-1.50)
Asbestos on hands and clothes
Did not get on hands or clothes
17
2.32 (0.87-6.23)
Got on hands or clothes
49
0.82 (0.52-1.30)
Use of mask
Did not wear mask
55
0.95 (0.61-1.46)
Wore mask
11
1.43 (0.49-4.17)
Frequency of exposure
< 5 times/week
18
1.00 (0.50-2.00)
≥ 5 times/week
31
0.79 (0.43-1.46)
Brief, intense exposure
17
1.48 (0.64-3.38)
Ordinal trend
p = 0.70
Duration of exposure (years)
< 5
24
0.98 (0.53-1.84)
5-14
20
1.47 (0.67-3.22)
≥ 15
22
0.76 (0.39-1.49)
Continuous trend
p = 0.61
Ordinal trend
p = 0.81
Time since first exposure (years)
< 1-14
10
1.66 (0.54-5.10)
15-29
21
1.37 (0.65-2.91)
≥ 30
35
0.77 (0.45-1.31)
Continuous trend
p = 0.61
Ordinal trend
p = 0.66
Cumulative exposure index
1-30
41
1.26 (0.74-2.15)
31-60
11
0.80 (0.34-1.88)
≥ 61
14
0.65 (0.28-1.51)
Continuous trend
p = 0.22
Ordinal trend
p = 0.46
15-year latency
Exposed, latency > 15 years
56
0.93 (0.60-1.44)
Asbestos on hands and clothes
Did not get on hands or clothes
12
1.75 (0.62-4.94)
Got on hands or clothes
44
0.83 (0.51-1.33)
Use of mask
Did not wear mask
46
0.86 (0.55-1.37)
Wore mask
10
1.95 (0.55-6.90)
Frequency of exposure
< 5 times/week
14
0.83 (0.39-1.76)
≥ 5 times/week
30
0.93 (0.49-1.77)
Brief, intense exposure
12
1.14 (0.46-2.87)
Ordinal trend
p = 0.78
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Asbestos: Selected Cancers
Reference
Study Population
Exposed Cases
Estimated RR (95% CI)
Duration of exposure (years)
< 5
19
0.74 (0.37-1.47)
5-14
21
1.60 (0.75-3.44)
≥ 15
16
0.69 (0.30-1.55)
Continuous trend
p = 0.58
Ordinal trend
p = 0.79
Cumulative exposure index
1-30
36
1.07 (0.63-1.81)
31-60
10
0.94 (0.33-2.65)
≥ 61
10
0.55 (0.21-1.47)
Continuous trend
p = 0.33
Ordinal trend
p = 0.40
Gerhardson de Verdier et al. 1992
Colon and rectal cancer cases among male residents of Stockholm, Sweden; self-reported agents
163 colon cancers
22
1.9 (0.9-4.2)
Right colon
16
2.6 (1.2-5.9)
Left colon
3
0.5 (0.1-1.9)
107 rectal cancers
17
1.9 (0.8-4.6)
Colorectal cancer: latency (years)
1-19
5
1.4 (0.3-9.9)
20+
34
2.0 (1.0-3.9)
1-29
12
1.6 (0.5-5.0)
30+
27
2.0 (1.0-4.4)
1-39
22
1.4 (0.7-3.0)
40+
17
3.2 (1.1-11.5)
Neuget et al. 1991
51 colorectal cancer cases among males undergoing colonoscopy in 3 NYC medical centers
Asbestos exposure
10
1.8 (0.8-5.6)
Significant exposure
3
4.3 (0.8-23.5)
Fredriksson et al. 1989
329 colon cancer cases among residents of Umea, Sweden
Asbestos, low grade
na
1.2 (0.6-2.4)
Asbestos, high grade
na
2.1 (0.8-5.8)
Spiegelman and Wegman 1985
Colorectal cancer cases in seven US metropolitan areas and two states; JEM-derived agent
Males: 343 colorectal cancer
na
1.28 (p = 0.17)
224 colon cancer only
na
1.22 (p = 0.33)
Females: 208 colorectal cancer
na
1.08 (p = 0.65)
171 colon cancer only
na
1.09 (p = 0.64)
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Asbestos: Selected Cancers
Reference*
Study Population
Exposed Cases
Estimated RR (95% CI)
Hardell 1981
153 colon cancer cases among male residents of Umea, Sweden Asbestos, any
16
1.9 (1.0-3.6)
Hillerdal 1980
Gastrointestinal carcinoma cases among male residents of Uppsala county, Sweden (exposure = pleural plaques)
108 colon
3
1.67 (0.34-4.87)a
101 rectal
3
1.76 (0.36-5.16)a
NOTES: CI = Confidence interval; na = not available; RR = relative risk. Data points included in meta-analyses are bolded.
* Full citations can be found in the reference list for Chapter 6.
aOR and 95% CI calculated with standard methods from observed and expected numbers presented in original paper.
Representative terms from entire chapter:
colorectal cancer
