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Risk of mesothelioma after cessation of asbestos exposure: a systematic review and meta-regression

Abstract

Purpose

A ‘risk reversal’ has been observed for several human carcinogens following cessation of exposure, but it is unclear whether it also exists for asbestos-related mesothelioma.

Methods

We conducted a systematic review of the literature and identified nine studies that reported information on risk of mesothelioma after cessation of asbestos exposure, and performed a meta-regression based on random effects models. As comparison we analyzed results on lung cancer risk from four of these studies.

Results

A total of six risk estimates from five studies were included in the meta-analysis. The summary relative risk (RR) of mesothelioma for 10-year interval since cessation of exposure was 1.02 [95% confidence interval (CI) 0.87–1.19; p-heterogeneity 0.01]. The corresponding RR of lung cancer was 0.91 (95% CI 0.84–0.98).

Conclusions

This analysis provides evidence that the risk of mesothelioma does not decrease after cessation of asbestos exposure, while lung cancer risk does.

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Acknowledgements

The authors thank C. Pelucchi from the University of Milan, who produced original results for the study of Italian asbestos miners (Pira et al. 2017).

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Correspondence to Paolo Boffetta.

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Conflict of interest

PB, EP and CLV acted as experts for the defense (PB, EP, CLCV) and the court (EP, CLV) in asbestos-related litigation.

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Boffetta, P., Donato, F., Pira, E. et al. Risk of mesothelioma after cessation of asbestos exposure: a systematic review and meta-regression. Int Arch Occup Environ Health 92, 949–957 (2019). https://doi.org/10.1007/s00420-019-01433-4

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Keywords

  • Asbestos
  • Mesothelioma
  • Time since last exposure