Asbestos Selected Cancers (2006) / Chapter Skim
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11 Colorectal Cancer and Asbestos
11 Colorectal Cancer and Asbestos
Pages 216-229
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From page 216... ...
Other risk factors for colon cancer are obesity (especially in men) , physical inactivity, heavy consumption of alcohol and of red or processed meat, a history of inflammatory bowel disease, and a family history of colon or rectum cancer, especially in persons under 40 years old.
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From page 217... ...
Furthermore, the legislation driving the committee's charge specified colorectal cancer as a single endpoint. Age and sex are the primary known risk factors for rectal cancer, while colon cancer also appears more clearly associated with family history, physical inactivity, and several other factors such as body mass index and dietary and alcohol intake (Wei et al.
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From page 218... ...
Also, data on known risks (such as family history of colorectal cancer and/or diet) were not available in any of the cohort studies; because such non-occupational risk factors are not likely to have been associated with asbestos exposure, however, they probably do not represent important confounders.
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From page 219... ...
showed a small and marginally significant association between asbestos exposure and colorectal cancer (RR = 1.15, 95% CI 1.02-1.31)
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From page 220... ...
Woitowitz86 (CR, men + women, exposure stopped before 1972) Summary 95% Interval 0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 11.1 Cohort studies: RR of colorectal cancer in people with "any" exposure to asbestos compared with people who report none.
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From page 221... ...
0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 11.2 Cohort studies: RRs of colorectal cancer among people in most extreme exposure category compared to 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 222... ...
. In the colorectal case-control studies with higher-quality assessment of asbestos exposure, the summary estimate of association was essentially null (95% CI 0.75-1.29)
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From page 223... ...
. less rigorous classification of exposure and typically without adjustment for confounding -- were more likely to show associations between asbestos exposure and colorectal cancer.
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From page 224... ...
0.01 0.1 0.25 0.5 1 2 3 5 7 10 Relative Risk FIGURE 11.5 Case-control studies: RRs of colorectal cancer among people in most extreme exposure category compared to 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 225... ...
Multiple risk factors are associated with colon cancer, including age, familial predisposition, obesity, physical inactivity, and inflammatory bowel disease. The potential role of asbestos fibers as a cofactor has not been investigated in epidemiologic or experimental studies.
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From page 226... ...
No polyps were produced by chronic asbestos feeding in hamsters. Conclusion The committee judged that some aspects of the evidence were supportive of a causal association: a positive but small aggregate association with a narrow confidence band arising from the many cohort findings possible biologic plausibility suggested by the presence of asbestos bodies and fibers in the colons of asbestos workers and the experimental induction of colon polyps, albeit benign, in rats.
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From page 227... ...
1986. Mortality of asbestos cement workers using almost exclusively chrysotile fibre.
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From page 228... ...
1991. Association of asbestos exposure with colorectal adenomatous polyps and cancer.
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From page 229... ...
1986. Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust.
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