Journal Article
Asbestos exposure among primary lung cancer patients in Japan
Suganuma, N; Tamura, A; Funakoshi, M; Hasegawa, K; Ishimine, A; Koike, A; Tannai, N; Fujii, M; Hattori, M; Hirano, H; Nakamura, K; Funakoshi, M; Satomi, K; Yamashita, Y; Fukuchi, Y
American Journal of Respiratory and Critical Care Medicine
ISSN: 1073-449X
EISSN: 1535-4970
is part of a larger document
3452678 Proceedings of the American Thoracic Society 2010 International Conference, May 14-19, 2010, New Orleans
AIM: The impact of asbestos exposure among the primary lung cancer patient in Japan is not fully known. One of the surrogate markers for exposure to asbestos is detection of pleural plaque on the radiological images including chest radiograph and computed tomography (CT). As the CT scan gives cross-section of thorax, and gives clear view of anterior and posterior wall of thorax, CT is more sensitive than chest radiograph in detection of pleural plaque. In order to estimate the impact of asbestos exposure among lung cancer patient, we enumerated the frequency of asbestos related radiological findings among the case series of primary lung cancer patients in Japan.
MATERIALS & METHODS: Among the group hospitals of The Japan Federation of Democratic Medical Institutions (MIN-IREN) who responded our request to participate into the project were included into the participant hospitals. All the primary lung cancer patients pathologically diagnosed as primary lung cancer initially at the participant hospitals were included into the subjects. Nearest chest radiographs, chest computed tomography scans were interpreted according to the ILO 2000 international classification of radiographs of Pneumoconioses (ILO/ICRP), and the recently proposed International Classification of HRCT for Occupational and Environmental Respiratory Diseases (ICOERD), respectively. In order to objectify the detection of pleural plaque, we slightly modified ICOERD. All the radiological images were interpreted by panels of readers including occupational physician, chest physician, radiologist, and final decision was made by single US NIOSH B reader (NS). Clinical history including occupational and environmental exposure to asbestos was also collected by reviewing medical charts.
RESULTS: Total of 471 cases (339 male and 132 female patients) were analyzed. We are still on the process of accumulating subject cases. Average age of the subjects was 70.2+9.9 year-old, smokers were 76.4% (89.8% in male, 39.5% in female). Prevalence of plaque by chest radiograph was 5.9% (7.4% in male, 2.3% in female), while that by CT was 12.3% (15.6%, 3.8%). Plaque was found most on the chest wall (94.8%), followed by diaphragm (20.7%) and mediastinum (8.6%). Histological types were homogeneous regardless of presence of plaque.
DISCUSSION: This is the first report on prevalence of asbestos-related findings among primary lung cancer with large number subjects in Japan. The prevalence of plaque detected by CT was considerably high, reflecting the frequency of occupational and environmental exposure among the subject population. Medical attention with occupational and environmental heath perspective is needed to take care of these patients.
American Thoracic Society 2010 International Conference
New Orleans, LA
May 14-19, 2010
