Asbestos Selected Cancers (2006) / Chapter Skim
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8 Laryngeal Cancer and Asbestos
8 Laryngeal Cancer and Asbestos
Pages 173-192
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From page 173... ...
However, the incidence of laryngeal cancer, adjusted for age, has decreased by an average of 2.6% per year since 1988. Most cancers of the larynx are squamous-cell carcinomas that arise from the thin, flat cells (squamous cells)
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From page 174... ...
Premalignant lesions often regress after the discontinuation of tobacco use and alcohol consumption. The most important risk factors for laryngeal cancer are tobaccosmoking (all forms)
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From page 175... ...
Cohort Studies The cohorts that presented usable information about the risk of laryngeal cancer and their design properties are described in Table B.1, and the details of their results concerning cancer at this site are abstracted in Table D.2. The results of the cohort and case-control studies are summarized in Table 8.1, and Figures 8.2 and 8.3 are plots of RRs for overall exposure and for exposure-response gradients from the cohort studies reviewed.
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From page 176... ...
boundb EAM = 1 7 1.53 0.07 Upper (1.21-1.93) boundb NOTE: CI = Confidence interval; EAM = exposure-assessment method; high quality, EAM = 1; lower quality, EAM = 2; RR = relative risk; SD = standard deviation.
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From page 177... ...
Summary 95% Interval 0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 8.2 Cohort studies: RR of laryngeal cancer in people with "any" exposure to asbestos compared with people who report none. did not specify the standardized mortality ratio or expected number of cases of laryngeal cancer (e.g., Djerassi et al.
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From page 178... ...
0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 8.3 Cohort studies: RRs of laryngeal cancer among people in most extreme exposure category compared with those with no exposure ( = more than one exposure gradient reported in citation, so the plot contains both highest and lowest estimates of risk at most extreme category over all gradients)
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From page 179... ...
. Further analyses examined whether the association between asbestos exposure and laryngeal cancer was stronger among the most highly exposed subjects in a subset of 11 cohorts in which this information was available.
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From page 180... ...
To assess whether the association between asbestos exposure and risk of laryngeal cancer was stronger in studies with higher exposure information, the committee separated the studies into those with better measures of exposure and those with more limited data, as shown in Figure 8.5. The RR from the combined analysis of 10 studies with higher-quality exposure information was 1.21 (95% CI 1.04-1.40)
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From page 181... ...
Most of the case-control studies made some attempt to control for tobacco and alcohol consumption in examining the association between asbestos exposure and laryngeal cancer. Two of the studies whose results are presented in Figure 8.6 with adjustment for those risk factors also gave unadjusted estimates in the citation.
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From page 182... ...
Overall, with adjustment for the other two prominent risk factors for laryngeal cancer, an association with asbestos exposure appears to persist (RR = 1.18, 95% CI 1.011.37)
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From page 183... ...
. Five of the case-control studies presented results stratified by tobacco or alcohol consumption and allowed limited consideration of whether asbestos exposure might modify the laryngeal carcinogenicity of tobacco or alcohol exposure (Burch et al.
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From page 184... ...
A limitation of all of those studies is that, although the risk was higher among men who were exposed than those who were not unexposed to asbestos, the data were not stratified into narrowly defined combinations of asbestos exposure, tobacco-smoking, and alcohol consumption.
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From page 185... ...
0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 8.7 Case-control studies: RRs of laryngeal cancer in people in with extreme exposure to asbestos compared with those with none ( = more than one exposure gradient reported in citation, so the plot contains both highest and lowest estimates of risk for most extreme category over all gradients)
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From page 186... ...
Consistency Asbestos exposure was associated with increased risk of laryngeal cancer in all nine large cohort studies (those with at least 10 cases of or deaths from laryngeal cancer) and in both the cohort and case-control combined analyses.
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From page 187... ...
Asbestos exposure is an established cause of lung cancer. On the basis of theoretical considerations, tobacco-smoking, alone or in combination with alcohol consumption, may predispose to the accumulation of asbestos fibers in the epithelial lining of the larynx.
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From page 188... ...
1988. Occupational risk factors for laryngeal cancer on the Texas Gulf Coast.
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From page 189... ...
2002. Occupational dust exposure and the risk of laryngeal cancer in Turkey.
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From page 190... ...
1984. Dust exposure and mortality in an American chrysotile asbestos friction products plant.
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From page 191... ...
1992. Tobacco, alcohol, asbestos, and occupational risk factors for laryngeal cancer.
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From page 192... ...
1992. A case-control study of occupational risk factors for laryngeal cancer.
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