Are lung and pleural benign asbestos induced diseases a preliminary step in the pathogenic process of mesothelioma and lung cancer development?

Asbestos is and will remain for decades a major public health problem in many countries: it has been estimated that in Western Europe alone, about 500 000 cancer deaths due to asbestos exposure will occur up to 2029.1 Apart from being of public health concern, there are some major scientific questions about the health effects of asbestos exposure: What are the specific chemical and morphological characteristics of asbestos fibres involved in carcinogenesis? Is fibre persistency in the lung parenchyma an important determinant of the risk of developing a malignant mesothelioma? Is the potency for lung cancer induction the same regardless the type of asbestos fibres (chrysotile, amosite, crocidolite, tremolite, anthophyllite)? Is lung or pleural fibrosis a preliminary step in the process of mesothelioma and lung cancer development?

Research done by pathologists, biologists, and epidemiologists, provides findings that may be crucial to answer these questions.2 It would be of utmost importance to better understand the relations between benign pleural diseases (plaques and pleural calcification, pleural thickening), pulmonary fibrosis (asbestosis), and the risks of lung cancer and malignant mesothelioma. Most studies that looked at asbestos induced benign pleural and/or lung diseases among patients …