Cholangiocarcinoma and Occupational Exposure to Asbestos: Insights From the Italian Pooled Cohort Study
Main Article Content
Keywords
Cholangiocarcinoma, Asbestos Exposure, Cohort study, Cancer Registries
Abstract
Background: Recent studies supported the association between occupational exposure to asbestos and risk of cholangiocarcinoma (CC). Aim of the present study is to investigate this association using an update of mortality data from the Italian pooled asbestos cohort study and to test record linkage to Cancer Registries to distinguish between hepatocellular carcinoma (HCC) and intrahepatic/extrahepatic forms of CC. Methods: The update of a large cohort study pooling 52 Italian industrial cohorts of workers formerly exposed to asbestos was carried out. Causes of death were coded according to ICD. Linkage was carried out for those subjects who died for liver or bile duct cancer with data on histological subtype provided by Cancer Registries. Results: 47 cohorts took part in the study (57,227 subjects). We identified 639 causes of death for liver and bile duct cancer in the 44 cohorts covered by Cancer Registry. Of these 639, 240 cases were linked to Cancer Registry, namely 14 CC, 83 HCC, 117 cases with unspecified histology, 25 other carcinomas, and one case of cirrhosis (likely precancerous condition). Of the 14 CC, 12 occurred in 2010-2019, two in 2000-2009, and none before 2000. Conclusion: Further studies are needed to explore the association between occupational exposure to asbestos and CC. Record linkage was hampered due to incomplete coverage of the study areas and periods by Cancer Registries. The identification of CC among unspecific histology cases is fundamental to establish more effective and targeted liver cancer screening strategies.
References
1. Banales JM, Cardinale V, Carpino G, et al. Expert con-sensus document: Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA). Nat Rev Gastroenterol Hepatol. 2016 May;13(5):261-280.
2. Cardinale V, Semeraro R, Torrice A, et al. Intrahepatic and extrahepatic cholangiocarcinoma: New insight into epidemiology and risk factors. World J Gastrointest Oncol. 2010 Nov 15;2(11):407-416.
3. Hemminki K, Försti A, Hemminki O, et al. Long-term incidence and survival trends in cancer of the gallbladder and extrahepatic bile ducts in Denmark, Finland, Nor-way and Sweden with etiological implications related to Thorotrast. Int J Cancer. 2022 Jul 15;151(2):200-208.
4. Bergquist A, von Seth E. Epidemiology of cholan-giocarcinoma. Best Pract Res Clin Gastroenterol. 2015 Apr;29(2):221-232.
5. Mancini S, Bucchi L, Zamagni F, et al. Trends in Liver Cancer Incidence and Survival in Italy by Histologic Type, 2003-2017. Cancers (Basel). 2022 Dec 14;14(24):6162.
6. Florio AA, Ferlay J, Znaor A, et al. Global trends in intrahepatic and extrahepatic cholangiocarcinoma incidence from 1993 to 2012. Cancer. 2020 Jun 1;126(11):2666-2678.
7. Alvaro D, Crocetti E, Ferretti S, et al. Descriptive epide-miology of cholangiocarcinoma in Italy. Dig Liver Dis. 2010 Jul;42(7):490-495.
8. Bertuccio P, Malvezzi M, Carioli G, et al. Global trends in mortality from intrahepatic and extrahepatic cholangiocarcinoma. J Hepatol. 2019 Jul;71(1):104-114.
9. Brandi G, Tavolari S. Asbestos and Intrahepatic Chol-angiocarcinoma. Cells. 2020 Feb 12;9(2):421.
10. Khan SA, Tavolari S, Brandi G. Cholangiocarcinoma: Epidemiology and risk factors. Liver Int. 2019 May;39 Suppl 1:19-31.
11. Kumagai S, Kurumatani N, Arimoto A, Ichihara G. Cholangiocarcinoma among offset colour proof printing workers exposed to 1,2-dichloropropane and/or dichloromethane. Occup Environ Med. 2013 Jul;70(7):508-510.
12. Kumagai S, Sobue T, Makiuchi T, et al. Relationship between cumulative exposure to 1,2-dichloropropane and incidence risk of cholangiocarcinoma among offset printing workers. Occup Environ Med. 2016 Aug;73(8):545-552.
13. Vlaanderen J, Straif K, Martinsen JI, et al. Cholangiocarcinoma among workers in the printing industry: using the NOCCA database to elucidate the generalisability of a cluster report from Japan. Occup Environ Med. 2013 Dec;70(12):828-830.
14. Brandi G, Straif K, Mandrioli D, et al. Exposure to Asbestos and Increased Intrahepatic Cholangiocarcinoma Risk: Growing Evidences of a Putative Causal Link. Ann Glob Health. 2022 Jun 13;88(1):41.
15. Brandi G, Di Girolamo S, Farioli A, et al. d Asbestos: a hidden player behind the cholangiocarcinoma increase? Findings from a case-control analysis. Cancer Causes Control. 2013 May;24(5):911-918.
16. Farioli A, Straif K, Brandi G, et al. Occupational exposure to asbestos and risk of cholangiocarcinoma: a population-based case-control study in four Nordic countries. Occup Environ Med. 2018 Mar;75(3):191-198.
17. Vasuri F, Deserti M, Corradini AG, et al. Asbestos ex-posure as an additional risk factor for small duct intrahepatic cholangiocarcinoma: a pilot study. Sci Rep. 2023 Feb 13;13(1):2580.
18. Grosso F, Croce A, Libener R, et al. Asbestos fiber identification in liver from cholangiocarcinoma patients living in an asbestos polluted area: a preliminary study. Tumori. 2019 Oct;105(5):404-410.
19. Cook PM. Review of published studies on gut penetra-tion by ingested asbestos fibers. Environ Health Perspect. 1983 Nov;53:121-30.
20. Brandi G, Tavolari S. Asbestos and Intrahepatic Chol-angiocarcinoma. Cells. 2020 Feb 12;9(2):421.
21. Theise ND, Saxena R, Portmann BC, et al. The canals of Hering and hepatic stem cells in humans. Hepatology. 1999 Dec;30(6):1425-33.
22. Grosso F, Randi L, Croce A, et al. Asbestos fibers in the gallbladder of patients affected by benign biliary tract diseases. Eur J Gastroenterol Hepatol. 2015 Jul;27(7):860-4.
23. Ferrante D, Angelini A, Barbiero F, et al. Cause specific mortality in an Italian pool of asbestos workers cohorts. Am J Ind Med. 2024 Jan;67(1):31-43.
24. Ferrante D, Chellini E, Merler E, et al. Italian pool of asbestos workers cohorts: mortality trends of asbestos-related neoplasms after long time since first ex-posure. Occup Environ Med. 2017 Dec;74(12):887-898.
25. Magnani C, Silvestri S, Angelini A, et al. Italian pool of asbestos workers cohorts: asbestos related mortality by industrial sector and cumulative exposure. Ann Ist Super Sanita. 2020 Jul-Sep;56(3):292-302.
26. Luberto F, Ferrante D, Silvestri S, et al. Cumulative as-bestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy. Environ Health. 2019 Aug 7;18(1):71.
27. Girardi P, Merler E, Ferrante D, et al. Factors Affect-ing Asbestosis Mortality Among Asbestos-Cement Workers in Italy. Ann Work Expo Health. 2020 Jul 1;64(6):622-635.
28. Barone-Adesi F, Ferrante D, Chellini E, et al. Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies. Occup Environ Med. 2019 Sep;76(9):611-616.
29. Azzolina D, Consonni D, Ferrante D, et al. Rate ad-vancement measurement for lung cancer and pleural mesothelioma in asbestos-exposed workers. Thorax. 2023 Aug;78(8):808-815.
30. World Health Organization. International Classification of Diseases for Oncology (ICD-O), 3rd ed., 1st revision. World Health Organization, 2013.
31. Tyczynski JE, Démaret E, Parkin DM. Standards and Guidelines for Cancer Registration in Europe. The ENCR Recommendations, IARC Technical Publica-tion No. 40; International Agency for Research on Cancer: Lyon, France, 2003.
32. Breslow NE, Day NE. Statistical methods in cancer research (Volume II): The design and analysis of co-hort studies. IARC Scientific Publication No. 82. Lyon, 1987:1-406.
33. Marsh GM, Youk AO, Stone RA, et al. OCMAP-PLUS: a program for the comprehensive analysis of occupational cohort data. J Occup Environ Med. 1998 Apr;40(4):351-362.
34. Rumgay H, Ferlay J, de Martel C, et al. Global, regional and national burden of primary liver cancer by subtype. Eur J Cancer. 2022 Jan;161:108-118.
35. Armstrong B. A simple estimator of minimum detect-able relative risk, sample size, or power in cohort studies. Am J Epidemiol. 1987 Aug;126(2):356-358.
36. Rutherford MJ, Arnold M, Bardot A, et al. Comparison of liver cancer incidence and survival by subtypes across seven high-income countries. Int J Cancer. 2021 Dec 15;149(12):2020-2031.
37. Bannon F, Di Carlo V, Harewood R, et al. Survival trends for primary liver cancer, 1995–2009: analysis of individual data for 578,740 patients from 187 popula-tion-based registries in 36 countries (CONCORD-2). Ann Cancer Epidemiol. 2019;3:6.
38. Liu Z, Jiang Y, Yuan H, et al. The trends in incidence of primary liver cancer caused by specific Results from the Global Burden of Disease Study 2016 and implications for liver cancer prevention. J Hepatol. 2019 Apr;70(4):674-683.
39. Askgaard G, Fleming KM, Crooks C, et al. Socioeco-nomic inequalities in the incidence of alcohol-related liver disease: A nationwide Danish study. Lancet Reg Health Eur. 2021 Jul 13;8:100172.
40. Casetta B, Videla AJ, Bardach A, et al. Association Be-tween Cigarette Smoking Prevalence and Income Level: A Systematic Review and Meta-Analysis. Nicotine Tob Res. 2017 Nov 7;19(12):1401-1407.
41. Wang Y, Kong L, Ye C, et al. Causal impacts of edu-cational attainment on chronic liver diseases and the mediating pathways: Mendelian randomization study. Liver Int. 2023 Nov;43(11):2379-2392.
42. International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risk to Humans. Some Chemicals Used as Solvents and in Polymer Manufacture. Lyon, France: IARC, 2017.
2. Cardinale V, Semeraro R, Torrice A, et al. Intrahepatic and extrahepatic cholangiocarcinoma: New insight into epidemiology and risk factors. World J Gastrointest Oncol. 2010 Nov 15;2(11):407-416.
3. Hemminki K, Försti A, Hemminki O, et al. Long-term incidence and survival trends in cancer of the gallbladder and extrahepatic bile ducts in Denmark, Finland, Nor-way and Sweden with etiological implications related to Thorotrast. Int J Cancer. 2022 Jul 15;151(2):200-208.
4. Bergquist A, von Seth E. Epidemiology of cholan-giocarcinoma. Best Pract Res Clin Gastroenterol. 2015 Apr;29(2):221-232.
5. Mancini S, Bucchi L, Zamagni F, et al. Trends in Liver Cancer Incidence and Survival in Italy by Histologic Type, 2003-2017. Cancers (Basel). 2022 Dec 14;14(24):6162.
6. Florio AA, Ferlay J, Znaor A, et al. Global trends in intrahepatic and extrahepatic cholangiocarcinoma incidence from 1993 to 2012. Cancer. 2020 Jun 1;126(11):2666-2678.
7. Alvaro D, Crocetti E, Ferretti S, et al. Descriptive epide-miology of cholangiocarcinoma in Italy. Dig Liver Dis. 2010 Jul;42(7):490-495.
8. Bertuccio P, Malvezzi M, Carioli G, et al. Global trends in mortality from intrahepatic and extrahepatic cholangiocarcinoma. J Hepatol. 2019 Jul;71(1):104-114.
9. Brandi G, Tavolari S. Asbestos and Intrahepatic Chol-angiocarcinoma. Cells. 2020 Feb 12;9(2):421.
10. Khan SA, Tavolari S, Brandi G. Cholangiocarcinoma: Epidemiology and risk factors. Liver Int. 2019 May;39 Suppl 1:19-31.
11. Kumagai S, Kurumatani N, Arimoto A, Ichihara G. Cholangiocarcinoma among offset colour proof printing workers exposed to 1,2-dichloropropane and/or dichloromethane. Occup Environ Med. 2013 Jul;70(7):508-510.
12. Kumagai S, Sobue T, Makiuchi T, et al. Relationship between cumulative exposure to 1,2-dichloropropane and incidence risk of cholangiocarcinoma among offset printing workers. Occup Environ Med. 2016 Aug;73(8):545-552.
13. Vlaanderen J, Straif K, Martinsen JI, et al. Cholangiocarcinoma among workers in the printing industry: using the NOCCA database to elucidate the generalisability of a cluster report from Japan. Occup Environ Med. 2013 Dec;70(12):828-830.
14. Brandi G, Straif K, Mandrioli D, et al. Exposure to Asbestos and Increased Intrahepatic Cholangiocarcinoma Risk: Growing Evidences of a Putative Causal Link. Ann Glob Health. 2022 Jun 13;88(1):41.
15. Brandi G, Di Girolamo S, Farioli A, et al. d Asbestos: a hidden player behind the cholangiocarcinoma increase? Findings from a case-control analysis. Cancer Causes Control. 2013 May;24(5):911-918.
16. Farioli A, Straif K, Brandi G, et al. Occupational exposure to asbestos and risk of cholangiocarcinoma: a population-based case-control study in four Nordic countries. Occup Environ Med. 2018 Mar;75(3):191-198.
17. Vasuri F, Deserti M, Corradini AG, et al. Asbestos ex-posure as an additional risk factor for small duct intrahepatic cholangiocarcinoma: a pilot study. Sci Rep. 2023 Feb 13;13(1):2580.
18. Grosso F, Croce A, Libener R, et al. Asbestos fiber identification in liver from cholangiocarcinoma patients living in an asbestos polluted area: a preliminary study. Tumori. 2019 Oct;105(5):404-410.
19. Cook PM. Review of published studies on gut penetra-tion by ingested asbestos fibers. Environ Health Perspect. 1983 Nov;53:121-30.
20. Brandi G, Tavolari S. Asbestos and Intrahepatic Chol-angiocarcinoma. Cells. 2020 Feb 12;9(2):421.
21. Theise ND, Saxena R, Portmann BC, et al. The canals of Hering and hepatic stem cells in humans. Hepatology. 1999 Dec;30(6):1425-33.
22. Grosso F, Randi L, Croce A, et al. Asbestos fibers in the gallbladder of patients affected by benign biliary tract diseases. Eur J Gastroenterol Hepatol. 2015 Jul;27(7):860-4.
23. Ferrante D, Angelini A, Barbiero F, et al. Cause specific mortality in an Italian pool of asbestos workers cohorts. Am J Ind Med. 2024 Jan;67(1):31-43.
24. Ferrante D, Chellini E, Merler E, et al. Italian pool of asbestos workers cohorts: mortality trends of asbestos-related neoplasms after long time since first ex-posure. Occup Environ Med. 2017 Dec;74(12):887-898.
25. Magnani C, Silvestri S, Angelini A, et al. Italian pool of asbestos workers cohorts: asbestos related mortality by industrial sector and cumulative exposure. Ann Ist Super Sanita. 2020 Jul-Sep;56(3):292-302.
26. Luberto F, Ferrante D, Silvestri S, et al. Cumulative as-bestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy. Environ Health. 2019 Aug 7;18(1):71.
27. Girardi P, Merler E, Ferrante D, et al. Factors Affect-ing Asbestosis Mortality Among Asbestos-Cement Workers in Italy. Ann Work Expo Health. 2020 Jul 1;64(6):622-635.
28. Barone-Adesi F, Ferrante D, Chellini E, et al. Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies. Occup Environ Med. 2019 Sep;76(9):611-616.
29. Azzolina D, Consonni D, Ferrante D, et al. Rate ad-vancement measurement for lung cancer and pleural mesothelioma in asbestos-exposed workers. Thorax. 2023 Aug;78(8):808-815.
30. World Health Organization. International Classification of Diseases for Oncology (ICD-O), 3rd ed., 1st revision. World Health Organization, 2013.
31. Tyczynski JE, Démaret E, Parkin DM. Standards and Guidelines for Cancer Registration in Europe. The ENCR Recommendations, IARC Technical Publica-tion No. 40; International Agency for Research on Cancer: Lyon, France, 2003.
32. Breslow NE, Day NE. Statistical methods in cancer research (Volume II): The design and analysis of co-hort studies. IARC Scientific Publication No. 82. Lyon, 1987:1-406.
33. Marsh GM, Youk AO, Stone RA, et al. OCMAP-PLUS: a program for the comprehensive analysis of occupational cohort data. J Occup Environ Med. 1998 Apr;40(4):351-362.
34. Rumgay H, Ferlay J, de Martel C, et al. Global, regional and national burden of primary liver cancer by subtype. Eur J Cancer. 2022 Jan;161:108-118.
35. Armstrong B. A simple estimator of minimum detect-able relative risk, sample size, or power in cohort studies. Am J Epidemiol. 1987 Aug;126(2):356-358.
36. Rutherford MJ, Arnold M, Bardot A, et al. Comparison of liver cancer incidence and survival by subtypes across seven high-income countries. Int J Cancer. 2021 Dec 15;149(12):2020-2031.
37. Bannon F, Di Carlo V, Harewood R, et al. Survival trends for primary liver cancer, 1995–2009: analysis of individual data for 578,740 patients from 187 popula-tion-based registries in 36 countries (CONCORD-2). Ann Cancer Epidemiol. 2019;3:6.
38. Liu Z, Jiang Y, Yuan H, et al. The trends in incidence of primary liver cancer caused by specific Results from the Global Burden of Disease Study 2016 and implications for liver cancer prevention. J Hepatol. 2019 Apr;70(4):674-683.
39. Askgaard G, Fleming KM, Crooks C, et al. Socioeco-nomic inequalities in the incidence of alcohol-related liver disease: A nationwide Danish study. Lancet Reg Health Eur. 2021 Jul 13;8:100172.
40. Casetta B, Videla AJ, Bardach A, et al. Association Be-tween Cigarette Smoking Prevalence and Income Level: A Systematic Review and Meta-Analysis. Nicotine Tob Res. 2017 Nov 7;19(12):1401-1407.
41. Wang Y, Kong L, Ye C, et al. Causal impacts of edu-cational attainment on chronic liver diseases and the mediating pathways: Mendelian randomization study. Liver Int. 2023 Nov;43(11):2379-2392.
42. International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risk to Humans. Some Chemicals Used as Solvents and in Polymer Manufacture. Lyon, France: IARC, 2017.
Article Sidebar
Published
Apr 24, 2024
Article Details
How to Cite
1.
Cholangiocarcinoma and Occupational Exposure to Asbestos: Insights From the Italian Pooled Cohort Study. Med Lav [Internet]. 2024 Apr. 24 [cited 2024 Jun. 8];115(2):e2024016. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/14649
Issue
Section
Original articles
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a CC BY-NC-SA 4.0 Creative Commons Attribution-NonCommercial ShareAlike 4.0 International License.
How to Cite
1.
Cholangiocarcinoma and Occupational Exposure to Asbestos: Insights From the Italian Pooled Cohort Study. Med Lav [Internet]. 2024 Apr. 24 [cited 2024 Jun. 8];115(2):e2024016. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/14649
