Abstract
ObjectivesAn estimated 125 million workers are exposed to asbestos worldwide. Asbestos is classified by the International Agency for Research on Cancer as a Group 1 carcinogen. The association between occupational asbestos exposure and kidney cancer is not well established however. This study aimed to determine the mortality and incidence of kidney cancer in workers who have been exposed to asbestos. We performed a systematic review and meta-analysis to evaluate the association between occupational asbestos exposure and kidney cancer.MethodsMedline, EMBASE, and Web of Science were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles on occupational asbestos exposure and kidney cancer. The studies reported the standardized mortality ratio (SMR) or standardized incidence ratio (SIR) of kidney cancer in workers exposed to asbestos. SMRs or SIRs with its 95% confidence interval (CI) were pooled using a fixed-effect model.ResultsForty-nine cohort studies involving 335 492 workers were selected for analysis. These studies included 468 kidney cancer deaths and 160 incident cases. The overall pooled-SMR of kidney cancer was 0.95 (95% CI: 0.86–1.05), with no significant heterogeneity (PQ = 0.09, I2 = 24.87%). The overall pooled-SIR of kidney cancer was 0.95 (95% CI: 0.79–1.11), with no significant heterogeneity (PQ = 0.68, I2 = 0.00%). Subgroup analysis did not find any increased association with occupational asbestos exposure. There was no evidence of publication bias with Egger’s test P values of 0.08 for mortality studies and 0.99 for incidence studies.ConclusionsThis systematic review and meta-analysis did not show evidence of association between occupational asbestos exposure and kidney cancer mortality or incidence.
Highlights
The World Health Organization estimates that there are about 125 million people exposed to asbestos in the workplace globally (Burki, 2009)
Renal cell cancer represents about 85% of kidney cancers, and renal pelvis cancer comprising the rest of kidney cancer cases (Lipworth et al, 2009)
This systematic review and meta-analysis assessed the association between occupational asbestos exposure and kidney cancer based on 49 cohort studies
Summary
The World Health Organization estimates that there are about 125 million people exposed to asbestos in the workplace globally (Burki, 2009). Work-related asbestos exposure is associated with about 233 000 deaths annually (Furaya et al, 2018). Renal cell cancer represents about 85% of kidney cancers, and renal pelvis cancer comprising the rest of kidney cancer cases (Lipworth et al, 2009). The mean age at diagnosis for renal cell cancer is in the early 60s, and in the late 60s for renal pelvis cancer (Lipworth et al, 2009). The 5-year survival rate for localized renal cell cancer cases is about 90% (Lipworth et al, 2009). The relationship between asbestos exposure and development of kidney cancer is not well understood
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