OA Epidemiology

Occupational Asbestos Exposure and Risk of Esophageal, Gastric and Colorectal Cancer in the Prospective Netherlands Cohort Study

Proceedings of the 2013 annual meeting of the Netherlands Epidemiology Society

Volume 1 Issue S1 Abstract 45

 

N.S.M. Offermans, Maastricht University Medical Centre,  The Netherlands
R. Vermeulen, Julius Center, UMC Utrecht; Utrecht University, the Netherlands
A. Burdorf, Erasmus MC, Rotterdam, The Netherlands
R.A. Goldbohm, TNO Quality of Life, Leiden, The Netherlands
A.P. Keszei, Maastricht University Medical Centre,  The Netherlands
T. Kauppinen, Institute of Occupational Health, Helsinki, Finland
H. Kromhout, Utrecht University, Utrecht, the Netherlands
P.A. van den Brandt, Maastricht University Medical Centre,  The Netherlands

Background
The evidence for an association between asbestos exposure and esophageal, gastric and colorectal cancer is limited with only a few studies addressing the influence of potential confounders, cancer subtypes, and the possible interaction between asbestos and smoking, certainly for relatively low exposure. We addressed these issues by studying the association between occupational asbestos exposure and esophageal, gastric and colorectal cancer in the prospective population-based Netherlands Cohort Study (NLCS).

Methods
The NLCS includes 58279 men aged 55-69 years at enrollment in 1986. Based on job history information obtained from a self-administered questionnaire, asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal cancer cases, 486 gastric cancer cases, and 1724 colorectal cancer cases were available for analysis.

Results
Occupational asbestos exposure was not associated with esophageal, gastric and colorectal cancer risk. Correcting for potential confounders only affected associations with gastric cancer which became non-significant after correcting for especially smoking status and family history of gastric cancer. For cancer subtypes per organ, ever highly exposed to asbestos versus never highly exposed showed a borderline  significant association with esophageal squamous cell carcinoma (ESCC) (HR=2.01,95%CI:1.01-4.01) and a non-significant association with cancer of the rectum (HR1.27=,95%CI:0.93-1.73). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers.

Conclusions
This prospective population-based study showed no association between relatively low asbestos exposure and risk of esophageal, gastric and colorectal cancer. Higher asbestos exposure may entail an increased risk of ESCC.

Published: 06 Jun, 2013

 
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