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Meta-Analysis
. 2024 Feb 9;21(2):205.
doi: 10.3390/ijerph21020205.

Benzene Exposure and Lung Cancer Risk: A Systematic Review and Meta-Analysis of Human Studies

Manuela Chiavarini  1 , Patrizia Rosignoli  2 , Beatrice Sorbara  2 , Irene Giacchetta  3 , Roberto Fabiani  1
Affiliations
Meta-Analysis

Benzene Exposure and Lung Cancer Risk: A Systematic Review and Meta-Analysis of Human Studies

Manuela Chiavarini et al. Int J Environ Res Public Health. .

Abstract

Lung cancer is a leading cause of death with nearly 1.8 million deaths estimated worldwide in 2020. Although benzene is classified as a human carcinogen (Group 1) on the basis of its association with acute myeloid/non-lymphocytic leukaemia, there is still limited evidence that it may influence lung cancer risk. This study examined the potential link between benzene exposure and risk of lung cancer using a systematic review of epidemiological studies and meta-analysis. We searched through PubMed, Web of Science and Scopus databases up to 10 February 2023 to identify all articles on the association between benzene exposure and lung cancer (incidence or prevalence) and/or mortality. We extracted the risk estimates of the highest and the lowest reported categories of benzene exposure and conducted a meta-analysis using a random-effects model. Heterogeneity and publication bias were analysed using an I2 test and funnel plots asymmetry, respectively. Twenty-one studies were included in the final analysis, with a total of 10,750 lung cancer cases and 2899 lung cancer deaths. Overall, risk estimates of lung cancer prevalence and mortality in association with benzene exposure were 1.20 (n = 14; 95% CI 1.05-1.37) and 1.15 (n = 13; 95% CI 1.02-1.30), respectively. In all cases, heterogeneity was quite large, while no significant publication bias was observed. When only studies that adjusted for smoking habit were selected, the risk for lung cancer increased by up to 34% (n = 9; 95% CI 1.10-1.64). Our data, which show a strong association between benzene exposure and lung cancer risk, may have important public health implications. However, further studies are needed to identify the lung cancer risk associated with benzene exposure considering different smoking conditions.

Keywords: benzene; incidence; lung cancer; meta-analysis; mortality; occupational exposure.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the systematic literature search on benzene exposure patterns and lung cancer risk.
Figure 2
Figure 2
Forest plots showing the lung cancer risk expressed considering incidence and prevalence (a) [23,24,25,26,27,30,31,32,34,35,36,37,39] and mortality; (b) [28,29,31,33,35,37,38,40,41,42,43] associated with the highest benzene exposure compared with the lowest benzene exposure.
Figure 3
Figure 3
Funnel plots of the meta-analysis on lung cancer incidence/prevalence (a) and mortality (b) risk.
See this image and copyright information in PMC

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