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) |
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. |
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) |
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 |
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) |
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. |
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. |
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. |
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 |
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 |
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) |
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. |