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Digestive cancers and occupational asbestos exposure: incidence study in a cohort of asbestos plant workers
  1. Mathilde Boulanger1,2,3,
  2. Fabrice Morlais2,
  3. Véronique Bouvier4,
  4. Françoise Galateau-Salle5,
  5. Lydia Guittet2,3,
  6. Marie-France Marquignon1,
  7. Christophe Paris6,7,8,
  8. Claude Raffaelli9,
  9. Guy Launoy2,3,4,
  10. Bénédicte Clin1,2,3
  1. 1Service de santé au travail et pathologie professionnelle, CHU Caen, Caen, France
  2. 2INSERM, UMR 1086, Cancers et Populations, Caen, France
  3. 3Faculté de Médecine, Université de Caen, Caen, France
  4. 4Registre des tumeurs digestives du Calvados, Caen, France
  5. 5Service d'anatomopathologie, CHU Caen, Caen, France
  6. 6EA7298 INGRES, Nancy, France
  7. 7CHU Nancy, Nancy, France
  8. 8Faculté de Médecine, Université de Lorraine, Nancy, France
  9. 9Service de Santé au travail, GISTAF, Condé-sur-Noireau, France
  1. Correspondence to Dr Mathilde Boulanger, Service de santé au travail et pathologie professionnelle, CHU de Caen, Avenue de la Côte de Nacre, Caen 14033, Cedex, France; mathilde.boulanger{at}


Objective The aim of our study was to estimate the incidence of digestive cancers within a cohort of asbestos-exposed workers.

Methods Our study was based on a cohort of 2024 participants occupationally exposed to asbestos. The incidence of digestive cancers was calculated from 1 January 1978 to 31 December 2009 and compared with levels among the local general population using Standardised Incidence Ratios (SIRs). Asbestos exposure was assessed using the company’s job-exposure matrix.

Results 119 cases of digestive cancer were observed within our cohort, for an expected number of 77 (SIR=1.54 (1.28 to 1.85)). A significantly elevated incidence was observed for peritoneal mesothelioma, particularly in women. Significantly elevated incidences were also observed among men for: all digestive cancers, even when excluding peritoneal mesothelioma (SIR=1.50 (1.23 to 1.82)), oesophageal cancer (SIR=1.67 (1.08 to 2.47)) and liver cancer (SIR=1.85 (1.09 to 2.92)). Concerning colorectal cancer, a significant excess of risk was observed for men with exposure duration above 25 years (SIR=1.75 (1.05 to 2.73)).

Conclusions Our results are in favour of a link between long-duration asbestos exposure and colorectal cancer in men. They also suggest a relationship between asbestos exposure and cancer of the oesophagus in men. Finally, our results suggest a possible association with small intestine and liver cancers in men.

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