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Meta-Analysis
. 2022 Feb;11(3):778-789.
doi: 10.1002/cam4.4436. Epub 2022 Jan 14.

Relationship between exposure to ionizing radiation and mesothelioma risk: A systematic review of the scientific literature and meta-analysis

Giovanni Visci  1 , Emanuele Rizzello  2 , Carlotta Zunarelli  1 , Francesco Saverio Violante  1   3 , Paolo Boffetta  3   4
Affiliations
Meta-Analysis

Relationship between exposure to ionizing radiation and mesothelioma risk: A systematic review of the scientific literature and meta-analysis

Giovanni Visci et al. Cancer Med. 2022 Feb.

Abstract

Background: Ionizing radiation and mesothelioma have been examined among personnel employed in nuclear power plant and patients treated by external beam radiation therapy (EBRT). The association is still controversial; the purpose of this review is to summarize the scientific evidence published in the literature regarding the relationship between ionizing radiation and incidence of mesothelioma and, if possible, estimating strongness of the association by meta-analysis of extracted data.

Methods: Articles included in the systematic review were retrieved by searching among the three main scientific databases: PubMed, Scopus, and Embase. The literature search was conducted in June 2021. A meta-analysis of random effects was conducted, stratified by exposure (EBRT, occupational exposure). The heterogeneity of the summary relative risks (RRs) was assessed using I2 statistics. Publication bias was evaluated graphically through the funnel plot.

Findings: The exposure to ionizing radiation could be a risk factor for mesothelioma: both for exposure to high doses for short periods (EBRT) (RR of 3.34 [95% confidence interval, CI 1.24-8.99]) and for exposure to low doses for a prolonged duration (exposure working) (RR of 3.57 [95% CI 2.16-5.89]).

Conclusions: Despite the low number of mesotheliomas in the general population, the steadily increased risk among individuals exposed to radiation is still worth considering.

Keywords: ionizing radiation; mesothelioma; nuclear industry; radiotherapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart for the identification of articles for the meta‐analyses (PRISMA)
FIGURE 2
FIGURE 2
Forest plot of meta‐analysis of radiotherapy studies
FIGURE 3
FIGURE 3
Forest plot of meta‐analysis of radiotherapy studies (excluding the study by De Bruin et al. 16 )
FIGURE 4
FIGURE 4
Forest plot of meta‐analysis of nuclear workers studies
FIGURE 5
FIGURE 5
Funnel plot of the Egger's test to assess publication bias among radiotherapy studies
FIGURE 6
FIGURE 6
Funnel plot of the Egger's test to assess publication bias among nuclear workers studies
See this image and copyright information in PMC

Comment in

References

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