Asbestos Selected Cancers (2006) / Chapter Skim
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7 Pharyngeal Cancer and Asbestos
7 Pharyngeal Cancer and Asbestos
Pages 159-172
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From page 159... ...
In the study populations considered in this review, pharyngeal cancers would be expected to occur primarily in the oropharynx. Cancer of the nasopharynx is rare in the United States, where it occurs 159
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. The major risk factors for
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EPIDEMIOLOGIC EVIDENCE CONSIDERED Information on the association between asbestos exposure and cancer of the pharynx was available on 16 cohort populations with results presented in 14 articles and from six case-control studies. Cohort studies offer the opportunity to examine exposure-response trends, but the number of pharyngeal cancers in the cohort studies was generally too small to permit
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Both types of studies contributed evidence for the evaluation of asbestos and pharynx cancer. Cohort Studies The cohorts that presented usable information about the risk of pharyngeal cancer were indicated in Table 6.1.
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Summary 95% Interval 0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 7.2 Cohort studies: RR of pharyngeal cancer in people with "any" exposure to asbestos compared with people who report none. are plots of relative risks (RRs)
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Reference Study Pira05 (men + women) Summary 95% Interval 0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 7.3 Cohort studies: highest and lowest reported RRs of pharyngeal cancer among people in most extreme exposure category compared with those with none.
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Summary 95% Interval 0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 7.4 Case-control studies: RR of pharyngeal cancer in people with "any" exposure to asbestos compared with people with none. The committee found only six case-control studies that assessed the association between pharyngeal cancer and asbestos exposure.
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0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 7.5 Case-control studies: RR of pharyngeal cancer in people with "any" exposure to asbestos compared with people with none, stratified on quality of exposure assessment (top, EAM = 1: higher-quality exposure assessment; bottom, EAM = 2: lower-quality exposure assessment)
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From page 167... ...
Reference Study Summary 95% Interval Not Adjusted for SMK and ALC Luce00 (men + women) 0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 7.6 Case-control studies: RR of pharyngeal cancer in people with "any" exposure to asbestos compared with people with none, in studies with higher-quality exposure assessment, stratified on quality of confounder assessment (top: adjusted; bottom: unadjusted)
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From page 168... ...
Summary 95% Interval 0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 7.7 Case-control studies: RR of pharyngeal cancer among people in the most extreme exposure category compared with those with none. (If multiple exposure gradients were presented in study, highest and lowest estimates for the most extreme categories were plotted.)
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From page 169... ...
Coherence Squamous-cell carcinomas arising from the oropharynx and hypopharynx are similar to squamous-cell carcinomas of the lung and larynx in their histogenesis; however, they arise from oral and pharyngeal epithelium, which differs from the respiratory epithelium from which lung and laryngeal cancers arise. The major risk factors for pharyngeal cancer are tobacco-smoking, tobacco-chewing, and use of snuff alone or in combination with alcohol consumption.
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Nonetheless, several of the positive cohort studies and at least one case-control study support the determination that the evidence is suggestive but not sufficient to infer a causal relationship between asbestos exposure and pharyngeal cancer. REFERENCES Battista G, Belli S, Comba P, Fiumalbi C, Grignoli M, Loi F, Orsi D, Paredes I
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1996. Larynx preservation in pyriform sinus cancer: Preliminary results of a European Organization for Research and Treatment of Cancer phase III trial.
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1990. An update of cancer mortality among chrysotile asbestos miners in Balangero, northern Italy.
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