Lung Cancer Causes and Consequences

Transcription

1 Lung Cancer Causes and Consequences James D. Crapo, MD University of Colorado Denver Denver, CO

2 James D. Crapo, M.D., is a professor of medicine at the University of Colorado Denver, Division of Pulmonary Sciences and Critical Care. He is also chair of the Department of Medicine at the National Jewish Center. Dr. Crapo has numerous publications, including in the area of pulmonology. He specializes in internal medicine and pulmonary disease.

3 Lung Cancer Causes and Consequences Table of Contents I. Smoking and Lung Cancer II. Asbestosis III. Asbestosis and Lung Cancer IV. Interstitial Lung Disease and Lung Cancer V. Lung Distribution of Lung Cancer Compared to Deposition of Smoke and Asbestos Fibers VI. Inflammation Mechanism Linking Asbestosis and Lung Cancer VII. References Lung Cancer Causes and Consequences Crapo 527

4

5 Lung Cancer Causes and Consequences I. Smoking and Lung Cancer Cancer Prevention Study I (CPS-I) (study period ) by American Cancer Society. Relative risk = for men and 2.69 for women. Cancer Prevention Study II (CPS-II)- (study period ) by American Cancer Society. Relative risk = for men and for women. Thun, et al (2013) (study period ). Relative risk = for men and for women. Daily cigarette consumption peaked in the 1960s for men and during the 1980s for women. Typical age at initiation of smoking is years old for men and for women. Mean duration of smoking is years. Development of COPD in a smoker is associated with a 2-4 fold increase in risk of lung cancer. Life Expectancy: Shortened by >10 years among current adult smokers compared with never smokers. Quiting smoking at age results in a gain in life expectancy of about 10 years. Quiting smoking at age results in a gain in life expectancy of about 9 years. Quiting smoking at age results in a gain in life expectancy of about 6 years. II. Asbestosis Radiographic evidence of asbestosis (0/1, and greater) has been associated with increased risk of lung cancer with the magnitude of risk directly associated with severity of the asbestosis. All major types of lung cancer have been shown to occur at increased frequency in smokers when asbestosis is present (eg: squamous cell, adenocarcinoma, large cell and small cell). Threshold of exposure below which no cases of asbestos are expected to occur is 25 f/cc/years. Incidence of asbestosis at 75 to 100 f/cc/years of exposure is 1-2%. New cases of asbestosis are now rare due to Industrial Hygiene controls that were established in 1970s-1980s. Asbestosis usually occurs/initiates in proximity in time to when high level exposures occurred. Pulmonary fibrosis beginning decades after asbestos exposure is more likely due to another cause, such as IPF. III. Asbestosis and Lung Cancer Synergism between asbestos exposure and lung cancer is actually a synergism with asbestosis. Cohorts with no asbestosis have no increased risk of lung cancer. Cohorts with only low level asbestos exposure have no increased risk of lung cancer. Within cohorts with asbestosis, when studied, only subjects with asbestosis show an increased association with lung cancer. Lung Cancer Causes and Consequences Crapo 529

6 Pleural plaques are a marker of asbestos exposures, but not a reliable marker of increased risk for lung cancer. Animal inhalation studies show excess lung tumors only when lung fibrosis is produced. IV. Interstitial Lung Disease and Lung Cancer Lung fibrosis of many different etiologies has been associated with an increased risk of lung cancer (Meyer, et al 1965, Fraire & Greenberg 1973, Turner-Warwick, et al 1980). V. Lung Distribution of Lung Cancer Compared to Deposition of Smoke and Asbestos Fibers The majority of lung cancers occur in the proximal airways, commonly at airway bifurcations. Asbestos fibers are retained in the distal lung parenchyma, with fibers rarely found in the walls of the more proximal airway walls. The distribution of tobacco smoke residue accumulation correlates with the common distribution of lung cancers. VI. Inflammation Mechanism Linking Asbestosis and Lung Cancer Rom, Travis & Brody (1991) Asbestosis is an inflammatory and fibrotic process... mediated, at least in part, by cytokines released by alveolar macrophages... The processes of inflammation, fibrosis, and carcinogenesis appear to be closely inter-twined. For example, proto-oncogenes such as c-sis (PDFG-B-chain) are upregulated in activated alveolar macrophages from fibrotic lungs; these and possibly others may play an important role in asbestos carcinogensis. 530 Asbestos Medicine November 2013

7 Jones, Hughes & Weill (1996) An inflammatory response causing cell proliferation... would produce linkage, even with fibrosis and cancer expressed at different sites in the lung. Cagle (2002)... asbestosis develops when asbestos fibers stimulate inflammatory cells to produce a variety of mediators of fibrogenesis eg, growth factors, cytokines and oxidative damage... The role of these mediators in both fibrogenesis and caracinogenesis provides a basis for the.. increased risk of lung cancer in patients with asbestosis. VII. References 1. Acheson ED et al. Cancer in a factory using amosite asbestos. Int J Epidemiol 13(1):3-10, Akira M, Yamamoto S, Inoue Y, Sakatani M. High-resolution CT of asbestosis and idiopathic pulmonary fibrosis. Am J Radiol 181: , Alberg AJ and Samet JM. Epidemiology of lung cancer. Chest 123(1):21S-49S, Armstrong BK et al. Mortality in miners and millers of crocidolite in Western Australia. Br J Ind Med 45:5-13, Berman WD and Crump KS. Update of potency factors for asbestos-related lung cancer and mesothelioma. Crit Rev Toxicol 38:1-47, Berman WD and Crump KS. A meta-analysis of asbestos-related cancer risk that addresses fiber size and mineral type. Crit Rev Toxicol 38:49-73, Cagle P. Criteria for attributing lung cancer to asbestos exposure. Editorial. Am J Clin Pathol 117:9-15, Cagle PT. Carcinoma of the lung. Chapter 17 in: Thurlbeck s Pathology of the Lung, Churg AM et al., eds., New York: Thieme Medical Publishers, Inc., pp , Camus M, Siemiatycki J, Meek B. Nonoccupational exposure to chrysotile asbestos and the risk of lung cancer. New Engl J Med 338(22): , Churg A. Neoplastic asbestos-induced disease. In: Pathology of Occupational Lung Disease, Churg and Green, editors, 2nd Edition, Baltimore: Williams & Wilkins, p 341, Churg A. Non-occupational exposure to chrysotile asbestos and the risk of lung cancer. New Engl J Med 339(14): , Clemmesen J and Hjalgrim-Jensen S. Cancer incidence among 5686 asbestos-cement workers followed from Ecotoxicology and Environmental Safety 5:15-23, Corrin B and Nicholson AG (eds.). Carcinoma of the Lung, Section 12.1 in Pathology of the Lungs, Philadelphia: Churchill Livingstone, pp , Corrin B and Nicholson AG (eds.) Asbestos-Induced Lung Cancer, Section 7.1 in Pathology of the Lungs, Philadelphia: Churchill Livingstone, pp , Craighead JE and Gibbs AR (eds.) Asbestos and Its Diseases, Oxford: University Press, Cullen MR, Barnett MJ, Balmes JR, Cartmel B, Redlich CA, Brodkin CA, Barnhart S, Rosenstock L, Goodman GE, Hammar SP, Thornquist MD, Omenn GS. Predictors of lung cancer among asbestos-exposed men in the{beta}-carotene and retinol efficacy trial. Am J Epidemiol 161(3):260-70, Fraire AD, Greenberg SC. Carcinoma and diffuse interstitial fibrosis of the lung. Cancer 31: , Lung Cancer Causes and Consequences Crapo 531

8 18. Fraser, Muller, Colmann, Pare. Diagnosis of Diseases of the Chest, 4th edition, Volume 2, Philadelphia: WB Saunders Co., pp , Gibbs A, Churg A, Weill H. Letter to the Editor: The Helsinki Criteria for Attribution of Lung Cancer to Asbestos Exposure: How Robust Are the Criteria? Arch Pathol Lab Med 131: , Goodman M et al. Cancer in asbestos-exposed occupational cohorts: a meta-analysis. Cancer Causes and Control 210: , Hammond EC, Selikoff IJ, Seidman H. Asbestos exposure, cigarette smoking and death rates. Ann N Y Acad Sci 330: , Hecht SS. Tobacco smoke carcinogens and lung cancer. J Natl Cancer Inst 91: , Henderson DW. Asbestos and Lung Cancer: Is It Attributable to Asbestosis or To Asbestos Fiber Burden? In: Pathology of Lung Tumors, Corrin B, ed, pp , Henderson, Douglas W. Letter to the Editor: Commentary regarding the article by Fischer et al.: Fibre years, pulmonary asbestos burden and asbestosis. Int J Hyg Environ Health 205: , Int J Hyg Environ Health 206: , Hessel PA, Gamble JF, McDonald JC. Asbestos, asbestosis, and lung cancer: a critical assessment of the epidemiological evidence. Thorax 60(5):433-6, Hodgson JT and Darnton A. The quantitative risks of mesothelioma and lung cancer in relation to asbestos exposure. Ann Occup Hyg 44(8): , 2000, (with response: Letters to the Editor: The quantitative risks of mesothelioma and lung cancer in relation to asbestos exposure. Ann Occup Hyg 45(4): , Hubbard R, Venn A, Lewis S, Britton J. Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am J Respir Crit Care Med 161:5-8, Hughes JM, et al. Mortality of workers employed in two asbestos cement manufacturing plants. Br J Ind Med 44: , Hughes JM, Weill H. Asbestosis as a precursor of asbestos related lung cancer: results of a prospective mortality study. Br J Ind Med 48:229, Jones RN. Asbestos exposure, asbestosis, and asbestos-attributable lung cancer. Thorax 51(2):S9- S15, Jha P, Ramasundarahettige C, Landsman V, Rostron B, Thun M, Anderson RN, McAfee T, Peto R. 21 st -century hazards of smoking and benefits of cessation in the United States. NEJM 368: , Karjalainen A, Pukkala E, Kauppinen T, Partanen T. Incidence of cancer among Finnish patients with asbestos-related pulmonary or pleural fibrosis. Cancer Causes Control 10(1):51-7, Kelley J. Occupational Lung Diseases Caused by Asbestos, Silica and Other Silicates. In: Baum s Textbook of Pulmonary Diseases, Crapo JD, Glassroth J, Karlinsky JB, King TE (eds), Philadelphia: Lippincott, Williams & Wilkins, Chapter 44, pp , Kipen HM, Lilis R, Suzuki Y, Valciukas JA, Selikoff IJ. Pulmonary fibrosis in asbestos insulation workers with lung cancer: a radiological and histopathological evaluation. Br J Ind Med 44:96-100, Asbestos Medicine November 2013

9 35. Koskinen K et al. Different measures of asbestos exposure in estimating risk of lung cancer and mesothelioma among construction workers. J Occup Environ Med 44: , Liddell FDK, McDonald JC. Radiological findings as predictors of mortality in Quebec asbestos workers. Br J Ind Med 37:257-67, Liddell FDK, McDonald AD, McDonald JC: The birth cohort of Quebec chrysotile miners and millers: development from 1904 and mortality to Am Occup Hyg 41:13-36, Liddell FDK, McDonald AD, McDonald J C. Dust exposure and lung cancer in quebec chrysotile miners and millers. Ann Occup Hyg 42(1):7-20, McDonald JC et al. Chrysotile Fibre Concentration and Lung Cancer Mortality: A Preliminary Report, pp , Meldrum M. Review of Fibre Toxicology (OELs). Health and Safety Executive Review, Mizel KN, Morris CG, Carter JE. Antemortem diagnosis of asbestosis by screening chest radiograph correlated with postmortem histologic features of asbestosis: a study of 273 cases. J Occup Med Toxicol 4:14, Morgan WKC, Seaton A. Occupational Lung Diseases, 3rd Edition, Lung Cancer, pp and Pulmonary Fibrosis, pp , Morgan and Reger. Occupational Lung Cancer. In: Occupational Lung Diseases, 3 rd Edition, Morgan WKC and Seaton A (eds), Chapter 24, Newhouse ML, Berry G, Wagner JC. Mortality of factory workers in East London. Br J Ind Med 42:4-11, Meyer EC, Liebow AA. Relationship of interstitial pneumonia honeycombing and atypical epithelial proliferation to cancer of the lung. Cancer 18: , Mossman BT et al. Mechanisms in the pathogenesis of asbestosis and silicosis. Am J Respir Crit Care Med 157: , Mossman BT et al. Pulmonary endpoints (lung carcinomas and asbestosis) following inhalation exposure to asbestos. J Toxicol Environ Health, Part B 14:76-121, Neuberger M, Kundi M. individual asbestos exposure: smoking and mortality - a cohort study in the asbestos cement industry. Br J Ind Med 47: , Newhouse ML and Sullivan KR. A mortality study of workers manufacturing friction materials: Br J Ind Med 46: , Roggli VL, Sanders LL. Asbestos content of lung tissue and carcinoma of the lung: a clinicopathologic correlation and mineral fiber analysis of 234 cases. Ann Occup Hyg 44(2):109-17, Roggli VL. Carcinoma of the Lung. In: Pathology of Asbestos-Associated Diseases, Roggli VL et al. (eds.), New York: Springer-Verlag, Chapter 7, Rossiter CE, Coles RM. HM Dockyard, Devonport: 1947 Mortality Study. Biological Effects of Mineral Fibres, WHO/IARC, Report of the Royal Commission on Matters of Health and Safety Arising from the Use of Asbestos in Ontario, Rom WN, Travis WD, Broday AR. Cellular and molecular basis of the asbestos-related diseases. Am Rev Respir Dis 143: , Lung Cancer Causes and Consequences Crapo 533

10 55. Selikoff IJ. Mortality experience of insulation workers in the United States and Canada Ann N Y Acad Sci 330:91-226, Sluis-Cremer GK, Bezuidenhout BN. Relation between asbestosis and bronchial cancer in amphibole asbestos miners. Br J Ind Med 46: , Suzuki Y, Selikoff IJ. Pathology of lung cancer among asbestos insulation workers; analysis of 534 consecutive cases. 79th Annual Meeting of the American Association for Cancer Research, May 25-28, Thun MJ, Carter BD, Feskanich D, Freedman ND, Prentis R, Lopez AD, Hartge P, Gapstur SM. 50-year trends in smoking-related mortality in the United States, NEJM 368: , Turner-Warsick M, Lebowitz M, Burrows B, Johnson A. Cryptogenic fibrosing alveolitis and lung cancer. Thorax 35: , U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking - 25 Years of Progress: A Report of the Surgeon General. Atlanta, Georgia, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, DHHS Publication No. (CDC) , U.S. Surgeon General. The Health Consequences of Smoking: A report of the Surgeon General. U.S. Department of Health and Human Services, U.S. Surgeon General. Women and Smoking: A report of the Surgeon General. U.S. Department of Health and Human Services, U.S. Surgeon General. The Health Consequences of Smoking: A report of the Surgeon General. U.S. Department of Health and Human Services, U.S. Surgeon General. The Health Consequences of Smoking: A report of the Surgeon General. U.S. Department of Health and Human Services, U.S. Surgeon General. The Health Consequences of Smoking: A report of the Surgeon General. U.S. Department of Health and Human Services, U.S. Surgeon General. The Health Consequences of Smoking: A report of the Surgeon General. U.S. Department of Health and Human Services, U.S. Surgeon General. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A report of the Surgeon General. U.S. Department of Health and Human Services, U.S. Surgeon General. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease. U.S. Department of Health and Human Services, Webb RW, Muller NL, Naidich DP (eds.) High-Resolution CT of the Lung, 4 th Edition, Lippincott Williams & Wilkins. 70. Weiss W. Asbestos-related pleural plaques and lung cancer. Chest 103: , Weiss W. Asbestosis: A marker for the increased risk of lung cancer among workers exposed to asbestos. Chest 115: , Asbestos Medicine November 2013