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Does exposure to asbestos cause prostate cancer? A systematic literature review and meta-analysis.

ABSTRACT: OBJECTIVE:The relationship between asbestos and prostate cancer (PCa) is not well understood due to small number of cases. This study aimed to determine the incidence and mortality of PCa among workers or residents exposed to asbestos based on a systematic review and meta-analysis METHODS: All published studies citing the standardized mortality ratio (SMR) or standardized incidence ratio (SIR) of PCa in workers or residents exposed to asbestos were collected by conducting a search on PubMed, EMBASE, Cochrane Library, and Web of Science before April 2018. Standardized mortality rate for PCa with its 95% confidence interval (CI) was pooled using a fixed-/random-effect model in STATA (Version14.0). This study is registered with PROSPERO, number CRD42018095195. RESULTS:A total of 17 independent studies were included for the analysis. The overall pooled SMR of PCa was 1.22, with a 95% CI of 1.13 to 1.32, with no heterogeneity across the studies (I?=?18.8%, P?=?.234). Subgroup analysis shows that exposure to crocidolite, cement, studies conducted in Europe and Oceania, and long study follow-up (?25 years) all contribute to significantly higher SMR, and we found no evidence of publication bias (Begg test P value?=?.592, Egger test P value?=?.874). CONCLUSIONS:This meta-analysis suggested that exposed to asbestos might be associated with an increased risk of PCa. High-exposure level of asbestos could contribute to significantly higher risk of PCa mortality.

SUBMITTER: Peng R

PROVIDER: S-EPMC6370155 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Does exposure to asbestos cause prostate cancer? A systematic literature review and meta-analysis.

Peng Rui R Fang Fang F Chen Zhijun Z Yang Shuai S Dai Changyuan C Wang Chengyong C Guan Han H Li Qingwen Q

Medicine 20190101 3

<h4>Objective</h4>The relationship between asbestos and prostate cancer (PCa) is not well understood due to small number of cases. This study aimed to determine the incidence and mortality of PCa among workers or residents exposed to asbestos based on a systematic review and meta-analysis METHODS: All published studies citing the standardized mortality ratio (SMR) or standardized incidence ratio (SIR) of PCa in workers or residents exposed to asbestos were collected by conducting a search on Pub ...[more]

PMID: 30653132

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Project description:OBJECTIVE:To determine the association between exposure to radiotherapy for the treatment of prostate cancer and subsequent second malignancies (second primary cancers). DESIGN:Systematic review and meta-analysis of observational studies. DATA SOURCES:Medline and Embase up to 6 April 2015 with no restrictions on year or language. STUDY SELECTION:Comparative studies assessing the risk of second malignancies in patients exposed or unexposed to radiotherapy in the course of treatment for prostate cancer were selected by two reviewers independently with any disagreement resolved by consensus. DATA EXTRACTION AND SYNTHESIS:Two reviewers independently extracted study characteristics and outcomes. Risk of bias was assessed with the Newcastle-Ottawa scale. Outcomes were synthesized with random effects models and Mantel-Haenszel weighting. Unadjusted odds ratios and multivariable adjusted hazard ratios, when available, were pooled. MAIN OUTCOME MEASURES:Second cancers of the bladder, colorectal tract, rectum, lung, and hematologic system. RESULTS:Of 3056 references retrieved, 21 studies were selected for analysis. Most included studies were large multi-institutional reports but had moderate risk of bias. The most common type of radiotherapy was external beam; 13 studies used patients treated with surgery as controls and eight used patients who did not undergo radiotherapy as controls. The length of follow-up among studies varied. There was increased risk of cancers of the bladder (four studies; adjusted hazard ratio 1.67, 95% confidence interval 1.55 to 1.80), colorectum (three studies; 1.79, 1.34 to 2.38), and rectum (three studies; 1.79, 1.34 to 2.38), but not cancers of the hematologic system (one study; 1.64, 0.90 to 2.99) or lung (two studies; 1.45, 0.70 to 3.01), after radiotherapy compared with the risk in those unexposed to radiotherapy. The odds of a second cancer varied depending on type of radiotherapy: treatment with external beam radiotherapy was consistently associated with increased odds while brachytherapy was not. Among the patients who underwent radiotherapy, from individual studies, the highest absolute rates reported for bladder, colorectal, and rectal cancers were 3.8%, 4.2%, and 1.2%, respectively, while the lowest reported rates were 0.1%, 0.3%, and 0.3%. CONCLUSION:Radiotherapy for prostate cancer was associated with higher risks of developing second malignancies of the bladder, colon, and rectum compared with patients unexposed to radiotherapy, but the reported absolute rates were low. Further studies with longer follow-up are required to confirm these findings.

Dataset Information

Does exposure to asbestos cause prostate cancer? A systematic literature review and meta-analysis.

Publications

Does exposure to asbestos cause prostate cancer? A systematic literature review and meta-analysis.

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