Meta-Analysis of the Association between Asbestos Exposure and Esophageal Cancer

Chih-Wei Wu, Hung-Yi Chuang, Dong-Lin Tsai, Tzu-Yu Kuo, Chen-Cheng Yang, Huang-Chi Chen and Chao-Hung Kuo
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Chih-Wei Wu: Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan
Hung-Yi Chuang: Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
Dong-Lin Tsai: Division of Thoracic Surgery, Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan
Tzu-Yu Kuo: Division of Pulmonary Medicine, Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan
Chen-Cheng Yang: Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan
Huang-Chi Chen: Cancer Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan
Chao-Hung Kuo: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan

IJERPH, 2021, vol. 18, issue 21, 1-22

Abstract: Background: We conducted a meta-analysis to quantitatively assess the association between asbestos exposure and esophageal cancer. Methods: We systematically collected articles from three electronic databases and calculated the pooled standardized mortality rate (SMR) from the meta-analysis. Subgroup analysis according to the type of asbestos exposure, follow-up years, sample size, industry classification, sex, and high-dose exposure was conducted. Results: From 242 studies, 34 cohort studies were included in our meta-analysis. Pooled SMR was positively associated with asbestos exposure and esophageal cancer (pooled SMR = 1.28; 95% confidence interval (CI) 1.19–1.38, p < 0.00001). In the subgroup analysis, (1) chrysolite, (2) four groups with follow-up over ten years, (3) the textile industry and shipyard, (4) both male and female, and (5) eight studies on highest asbestos exposure, all the subgroups showed significantly increased pooled SMRs. Conclusion: Asbestos exposure was significantly and positively associated with esophageal cancer, especially chrysolite. Considering the long latency period, we suggest that patients should be followed up for cancer, including esophageal cancer, for over ten years.

Keywords: asbestos exposure; esophageal cancer; carcinogen; occupational medicine; environmental medicine; meta-analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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