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Meta-Analysis
. 2015 May 26;112(11):1805-15.
doi: 10.1038/bjc.2014.599. Epub 2015 Apr 30.

Stomach cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies

L Fortunato  1 , L Rushton  1
Affiliations
Meta-Analysis

Stomach cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies

L Fortunato et al. Br J Cancer. .

Abstract

Background: A recent Monographs Working Group of the International Agency for Research on Cancer concluded that there is limited evidence for a causal association between exposure to asbestos and stomach cancer.

Methods: We performed a meta-analysis to quantitatively evaluate this association. Random effects models were used to summarise the relative risks across studies. Sources of heterogeneity were explored through subgroup analyses and meta-regression.

Results: We identified 40 mortality cohort studies from 37 separate papers, and cancer incidence data were extracted for 15 separate cohorts from 14 papers. The overall meta-SMR for stomach cancer for total cohort was 1.15 (95% confidence interval 1.03-1.27), with heterogeneous results across studies. Statistically significant excesses were observed in North America and Australia but not in Europe, and for generic asbestos workers and insulators. Meta-SMRs were larger for cohorts reporting a SMR for lung cancer above 2 and cohort sizes below 1000.

Conclusions: Our results support the conclusion by IARC that exposure to asbestos is associated with a moderate increased risk of stomach cancer.

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Figures

Figure 1
Figure 1
Meta-analysis of stomach cancer mortality and incidence for total cohort, all exposure lags.
Figure 2
Figure 2
Radial plot for SMRs in a meta- analysis of stomach cancer mortality and incidence for total cohort, all exposure lags.
Figure 3
Figure 3
Influence of excluding each individual cohort for men, mortality and incidence combined, all exposure lags. Meta-SMRs and associated 95% CI (random-effects model). Dotted and dash lines represent the overall meta-SMR and its 95% CI.
See this image and copyright information in PMC

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