Annals of Oncology Advance Access originally published online on October 9, 2006
Annals of Oncology 2007 18(6):985-990; doi:10.1093/annonc/mdl345
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2006 European Society for Medical Oncology
reviews |
Epidemiology of peritoneal mesothelioma: a review
International Agency for Research on Cancer, Lyon, France
* Correspondence to: Dr P. Boffetta, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France. Tel +33-4-72738554; Fax: +33-4-72738320; E-mail: boffetta{at}iarc.fr
 |
Abstract |
|---|
 Top Abstract introductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
The epidemiology of peritoneal mesothelioma is complicated by possible geographic and temporal variations in diagnostic practices. The incidence rates in industrialized countries range between 0.5 and three cases per million in men and between 0.2 and two cases per million in women. Exposure to asbestos is the main known cause of peritoneal mesothelioma. Results on peritoneal mesothelioma have been reported for 34 cohorts exposed to asbestos, among which a strong correlation was present between the percentages of deaths from pleural and peritoneal mesothelioma (correlation coefficient 0.8, P < 0.0001). Studies of workers exposed only or predominantly to chrysotile asbestos resulted in a lower proportion of total deaths from peritoneal mesothelioma than studies of workers exposed to amphibole or mixed type of asbestos. Cases of peritoneal mesothelioma have also been reported following exposure to erionite and Thorotrast, providing further evidence of common etiological factors with the pleural form of the disease. The role of other suspected risk factors, such as simian virus 40 infection and genetic predisposition, is unclear at present. Control of asbestos exposure remains the main approach to prevent peritoneal mesothelioma.
Key words: asbestos, epidemiology, peritoneal mesothelioma, thorotrast
|
introduction |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
The peritoneum is the second most frequent site of origin of mesothelioma, after the pleura. In developed countries, malignant mesothelioma (International Classification of Diseases for Oncology–Morphology codes 9050–9055) is the most frequent malignant neoplasm of the peritoneum [1]. Symptoms of peritoneal mesothelioma are unspecific, the most frequent being increased abdominal girth, pain and weight loss [2]; usually diagnosis occurs late. Treatment includes the combination of debulking surgery and i.p. chemotherapy. Survival remains poor; in the USA Surveillance, Epidemiology and End Results (SEER) cancer registry data median survival is 10 months and relative 5-year survival is 16% [3], however, in selected clinical series a longer survival (median >50 months) has been reported [2]. Although asbestos has been known for several decades to cause peritoneal mesothelioma, in addition to the pleural form of the disease [4], no detailed review of the epidemiological features of this disease has been published recently.
|
descriptive epidemiology |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
The descriptive epidemiology of peritoneal mesothelioma is complicated by temporal and geographic variability in diagnostic criteria. In addition, low sensitivity and low specificity of the diagnosis are important concerns, since mesothelioma of the peritoneum can be misdiagnosed as a neoplasm originating from other abdominal organs, notably adenocarcinoma from the ovary, and vice versa [5, 6]. Furthermore, sensitivity and specificity of the diagnosis may vary by place and time, thus complicating geographic and temporal analyses of the occurrence of the disease. Furthermore, given the strong association between asbestos and mesothelioma, knowledge of previous exposure might influence diagnostic accuracy; if this is the case, a diagnosis of peritoneal mesothelioma would be more frequently made for a patient with recognized past asbestos exposure than for a patient with a similar clinical presentation but without history of asbestos exposure.
The consequences of these potential biases are difficult to assess. Although it is likely that occurrence of peritoneal mesothelioma is underestimated in most populations, overestimation might occur in circumstances of recognized asbestos exposure. In general, caution should be used in the interpretation of the available data on the incidence and mortality from this disease.
Recent international data on the incidence of peritoneal mesothelioma are available from Eurocim, a collaboration of European population-based cancer registries [7], and from the SEER program of the United States [3]. Only sparse data are available from the other countries. Figure 1 reports the most recent data from selected nationwide European cancer registries and the SEER registries; at this level of aggregation, age-standardized incidence rates among men range from 0.5 to about three cases per million population. However, higher rates are reported in smaller areas with widespread past use of asbestos, such as the harbor city of Genoa, Italy (age-standardized rate in men in 1995, 5.5 per million). In most populations, rates among women are in the range 0.2–2 per million and are lower than in men; although in some countries, such as Sweden, rates are comparable in the two sexes. A correlation in incidence rates exists between the two sexes (correlation coefficient of 1991–1995 rates on the basis of 41 European and nine USA populations covered by cancer registry, 0.41; P = 0.003).
|
Figure 2 shows the temporal trend in peritoneal mesothelioma incidence among men in selected countries [3, 7]. Rates between 1971 and 1995 remained stable in Sweden and United States (SEER), while they have increased in countries such as Denmark and Scotland. The analysis of age-specific rates provides a deeper insight in the pattern of disease incidence, but it is feasible only in populations with a large enough number of cases to provide meaningful results. Figure 3 shows such rates in England during 1971–1995 (men only); a birth cohort effect is indicated, with the highest rates experienced by men born between 1920 and 1930. A decline in the last time periods is apparent among young men, indicating that the overall incidence might decline in the future. Age- and time-specific trends in women cannot be adequately studied because of random variability.
|
|
In an analysis of 50 European and USA populations [3, 7], the incidence rates of peritoneal mesothelioma in men were one order of magnitude lower than those of pleural mesothelioma. Rates of peritoneal mesothelioma among men showed only a modest correlation with that of the pleural form of the disease (Figure 4). A comparable analysis among women resulted in an even weaker correlation (correlation coefficient 0.14, P value 0.32). The modest correlation between peritoneal and pleural mesothelioma rates can be explained by differences in risk factors (e.g. circumstances of exposure to asbestos), but can also derive from bias in diagnostic and registration procedures.
|
|
exposure to asbestos |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
Data on the occurrence of peritoneal mesothelioma have been reported for 34 cohort studies of workers exposed to asbestos and asbestosis patients. The characteristics and key results of these cohorts are summarized in Table 1. A formal analysis of observed versus expected deaths (or cases) was presented in only few studies, because of difficulties in obtaining reliable reference rates. In order to provide some comparison between the cohorts, we used the proportion of peritoneal mesothelioma deaths over the total number of death as a measure of risk. This approach ignores differences in the age structure of the different study populations as well as temporal changes in the underlying rates. However, it is a relatively good indicator of the effect of an important determinant of the disease.
|
No peritoneal mesothelioma deaths were reported in 14 of the 34 studies; only two of these studies, however, comprised >1000 deaths, thus providing a reasonable power to detect a risk [13, 33]. The proportion over total deaths ranged in most of the remaining studies between 1/1000 and 1/100 (Table 1), with the exception of cohorts of cement workers from Canada [12], insulators from United States [29] and asbestosis patients from Italy [36] in which
4% of total deaths were from peritoneal mesothelioma. There was a strong correlation between the percentage of peritoneal mesothelioma deaths and both the percentage of pleural mesothelioma deaths (Figure 5) and the standardized mortality ratio of lung cancer (not shown in detail, correlation coefficient 0.85, P < 0.0001). The latter result replicates the finding of a previous analysis of a smaller number of cohort studies [41].
|
A higher proportion of studies of cohorts of workers exposed to chrysotile (either as unique or as predominant fiber type) reported no peritoneal mesothelioma deaths (nine of 15) as compared with studies of cohorts of workers to amphiboles or mixed fibers (four of 17; Table 2, column 3; chi-square test, P value 0.04). The proportion of mesothelioma deaths over total deaths was higher in cohorts exposed to amphiboles or mixed fibers than in cohorts exposed to chrysotile (Table 2), but the difference was not statistically significant (P value after adjustment for geographic region, 0.09). It was not possible to assess the effect of different types of amphibole fibers. Similar conclusions were noticed in a previous analysis of a smaller number of cohorts [41]. No effect of geographic region on the proportion of mesothelioma deaths over total deaths was detected [P value, on the basis of four regions (United States, UK, Western Europe, other countries) and adjusted for asbestos type, 0.9]. Only four studies were available of women (Table 1), pre-empting detailed analyses. No difference was found in the proportion of peritoneal mesothelioma deaths over total deaths according to diagnostic accuracy (death certificate versus best evidence, results not shown in detail). An effect of period of employment was apparent, with the cohorts of workers first employed before 1950 having a lower proportion of peritoneal mesothelioma deaths over total deaths than cohorts of workers employed later (P value after adjustment for geographic region, 0.005). This finding might reflect improved diagnostic accuracy during recent decades.
|
The dose–response relationship between occupational asbestos exposure and peritoneal mesothelioma risk has been investigated on the basis of the studies providing information on quantitative asbestos exposure [41]. The risk of peritoneal mesothelioma for workers exposed to amphiboles was proportional to the square of cumulative exposure, while a similar estimate could not be obtained for chrysotile-exposed workers [41, 42].
The important role of occupational exposure to asbestos in causing peritoneal mesothelioma has been confirmed in two community-based studies. A study from 24 of the United States [43] included 657 death certificates with peritoneal cancer (not specified as to histological type) as underlying cause recorded during 1984–1992. The occupation listed on the death certificate of these decedents (typically, the last occupation) was more frequently a job-entailing exposure to asbestos than the occupation of controls (deaths from other causes, matched 10 : 1 to cases). In particular, the odds ratio (OR) of peritoneal cancer was 180 [95% confidence interval (CI) 23, 1375] for insulation workers and 7.6 (95% CI 2.3, 25) for manufacturers of nonmetallic mineral products, including asbestos. When the authors applied a matrix for asbestos exposure on the basis of the jobs listed on the death certificate, they found a strong relationship with probability and intensity of exposure.
In a case–control study from Los Angeles and New York, USA, 20 cases of (or deaths from) peritoneal mesothelioma among men were compared with death certificate controls [44]. Interviews were conducted with next of kin. Exposure to asbestos, either self-reported or derived from occupational history, was present for 17 of the cases (OR 3.1, 95% CI 0.8, 15). The fraction of peritoneal mesothelioma attributable to asbestos exposure in this population was 58% (95% CI 20, 89).
Two studies provided evidence of an increased risk of peritoneal mesothelioma following nonoccupational exposure to asbestos. In a study from England, two cases of peritoneal mesothelioma were reported in women with household exposure [45]. No cases were reported among individuals with neighborhood exposure, while for seven cases, including three in men, there was no evidence of occupational or environmental exposure to asbestos. In a study from United States, eight cases of peritoneal mesothelioma were reported among women without occupational exposure; household exposure was reported for seven of them and residential exposure for three, including the case without household exposure [46]. In the case–control study from Los Angeles and New York mentioned above, no cases of peritoneal mesothelioma had residential exposure to asbestos [44].
|
exposure to other mineral fibers |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
Erionite is a silicate fiber belonging to the family of zeolites [47]. An increased risk of pleural mesothelioma and lung cancer has been reported among residents in a contaminated area from Cappadocia, Turkey, in which no sources of asbestos exposure were identified [48–50]. In particular, in a survey of 141 deaths in four villages, during 1979–1983, 29 deaths from pleural mesothelioma (20.5%) and four deaths from peritoneal mesothelioma (3.5%) were identified [50]. In a study of 162 Cappadocian migrants to Sweden, one case of peritoneal mesothelioma was identified [51].
There is no evidence of an increased risk of peritoneal mesothelioma among workers exposed to man-made vitreous fibers [52], although the available studies do not have a sufficient statistical power to detect a small increase in risk.
|
ionizing radiation |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
Three cohorts of patients receiving Thorotrast for radiological examinations reported results on peritoneal mesothelioma risk (Table 3). Although a formal estimate of the risk is complicated by uncertainties in the calculation of expected deaths, these patients experienced a cumulative incidence of peritoneal mesothelioma between 0.2% and 0.6%, higher than that of many cohorts of asbestos-exposed workers listed in Table 1. The incidence of peritoneal mesothelioma among Thorotrast patients was comparable with, or even greater than, that of pleural mesothelioma. The deposition of
-particles in abdominal organs adjacent to the peritoneum, such as the liver, spleen and lymph nodes is a plausible explanation of these findings. The time of appearance of peritoneal mesotheliomas in the Danish cohort of Thorotrast patients was longer than that of other cancers whose risk was also increased, such as liver and lung cancer [53]. An additional three cohorts of Thorotrast patients have been studied [56–58], but results for peritoneal mesothelioma have not been reported. The evidence on the risk of peritoneal mesothelioma following exposure to other sources of ionizing radiation is limited to a few case reports, e.g. of cancer patients who underwent radiotherapy [59].
|
|
other risk factors |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
A large number of studies detected sequences of the papovavirus, simian virus 40 (SV40) in samples of pleural mesothelioma [60]; however, the causal nature of this association has been questioned [61], and laboratory contamination may explain some of the findings [62]. In one of these studies, 11 German cases of peritoneal mesothelioma were also included, seven of which were positive for SV40 Tag sequences [63].
A possible role of chronic pancreatitis in peritoneal mesothelioma has been indicated, but not formally evaluated [64]. Genetic factors have been indicated to play a role in pleural mesothelioma [65]. Very limited information is available on the peritoneal form of the disease. In the case–control study from Los Angeles and New York mentioned above, the mother of an asbestos-exposed case of peritoneal mesothelioma was reported to have suffered from the same neoplasm [66]. No studies are available on other potential risk factors (e.g. nutrition).
|
conclusions |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
The rarity of the peritoneal mesothelioma and its diagnostic uncertainties limit our understanding of its epidemiological features. Asbestos is the main known cause of the disease, but other risk factors are likely to be involved in its etiology and pathogenesis. Although the evidence is not conclusive, this review of cohort and case–control studies indicates that the association between asbestos exposure and peritoneal mesothelioma is less strong than in the case of pleural mesothelioma. This might explain the relatively low correlation between the incidence of the two diseases. The other known risk factors explain only a very small proportion of cases of peritoneal mesothelioma. Despite these limitations, control of exposure to asbestos, in particular at the workplace, remains the main approach for the prevention of peritoneal mesothelioma.
Received for publication April 4, 2006. Revision received August 2, 2006. Accepted for publication August 18, 2006.
|
References |
|---|
|
TopAbstractintroductiondescriptive epidemiologyexposure to asbestosexposure to other mineral...ionizing radiationother risk factorsconclusionsReferences |
|---|
1. Mack TM. Sarcomas and other malignancies of soft tissue, retroperitoneum, peritoneum, pleura, heart, mediastinum, and spleen. Cancer (1995) 75:211–244.[CrossRef][Web of Science][Medline]
2. Mohamed F, Sugarbaker PH. Peritoneal mesothelioma. Curr Treat Options Oncol (2002) 3:375–386.[Medline]
3. Surveillance, Epidemiology, and EndResults (SEER) Program. SEER*Stat Database: Incidence—SEER 9 Regs Public-Use, Nov 2003 Sub (1973–2001), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2004, based on the November 2003 submission; http://www.seer.cancer.gov (28 September 2006, date last accessed).
4. Wagner JC, Gilson JC, Berry G, et al. Epidemiology of asbestos cancers. Br Med Bull (1971) 27:71–76.
5. Krasuski P, Poniecka A, Gal E. The diagnostic challenge of peritoneal mesothelioma. Arch Gynecol Obstet (2002) 266:130–132.[CrossRef][Medline]
6. Nielsen AM, Olsen JH, Madsen PM, et al. Peritoneal mesotheliomas in Danish women: review of histopathologic slides and history of abdominal surgery. Acta Obstet Gynecol Scand (1994) 73:581–585.[Web of Science][Medline]
7. European Network of Cancer Registries. Eurocim Version 4.0. European Incidence Database V2.3, CI5 Dictionary (2001) (2001) Lyon, France: IARC.
8. Jones JS, Smith PG, Pooley FD, et al. The consequences of exposure to asbestos dust in a wartime gas-mask factory. IARC Sci Publ (1980) 30:637–653.[Medline]
9. Acheson ED, Gardner MJ, Pippard EC, et al. Mortality of two groups of women who manufactured gas masks from chrysotile and crocidolite asbestos: a 40-year follow-up. Br J Ind Med (1982) 39:344–348.[Web of Science][Medline]
10. McDonald AD, McDonald JC, Pooley FD. Mineral fibre content of lung in mesothelial tumours in North America. Ann Occup Hyg (1982) 26:417–422.
11. Thomas HF, Benjamin IT, Elwood PC, et al. Further follow-up study of workers from an asbestos cement factory. Br J Ind Med (1982) 39:273–276.[Web of Science][Medline]
12. Finkelstein MM. Mortality among employees of an Ontario asbestos-cement factory. Am Rev Respir Dis (1984) 129:754–761.[Web of Science][Medline]
13. McDonald AD, Fry JS, Woolley AJ, et al. Dust exposure and mortality in an American chrysotile asbestos friction products plant. Br J Ind Med (1984) 41:151–157.[Web of Science][Medline]
14. Acheson ED, Gardner MJ, Winter PD, et al. Cancer in a factory using amosite asbestos. Int J Epidemiol (1984) 13:3–10.
15. Ohlson CG, Klaesson B, Hogstedt C. Mortality among asbestos-exposed workers in a railroad workshop. Scand J Work Environ Health (1984) 10:283–291.[Web of Science][Medline]
16. Peto J, Doll R, Hermon C, et al. Relationship of mortality to measures of environmental asbestos pollution in an asbestos textile factory. Ann Occup Hyg (1985) 29:305–355.
17. Ohlson CG, Hogstedt C. Lung cancer among asbestos cement workers. A Swedish cohort study and a review. Br J Ind Med (1985) 42:397–402.[Web of Science][Medline]
18. Kolonel LN, Yoshizawa CN, Hirohata T, et al. Cancer occurrence in shipyard workers exposed to asbestos in Hawaii. Cancer Res (1985) 45:3924–3928.
19. Alies-Patin AM, Valleron AJ. Mortality of workers in a French asbestos cement factory 1940 –82. Br J Ind Med (1985) 42:219–225.[Web of Science][Medline]
20. Szeszenia-Dabrowska N, Wilczynska U, Szymczak W. Risk of cancer in women occupationally exposed to asbestos dust. Med Pr (1986) 37:243–249.[Medline]
21. Woitowitz HJ, Lange HJ, Beierl L, et al. Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust. Int Arch Occup Environ Health (1986) 57:161–171.[CrossRef][Web of Science][Medline]
22. Seidman H, Selikoff IJ, Gelb SK. Mortality experience of amosite asbestos factory workers: dose–response relationships 5 to 40 years after onset of short-term work exposure. Am J Ind Med (1986) 10:479–514.[Web of Science][Medline]
23. Gardner MJ, Winter PD, Pannett B, et al. Follow up study of workers manufacturing chrysotile asbestos cement products. Br J Ind Med (1986) 43:726–732.[Web of Science][Medline]
24. Hughes JM, Weill H, Hammad YY. Mortality of workers employed in two asbestos cement manufacturing plants. Br J Ind Med (1987) 44:161–174.[Web of Science][Medline]
25. Amandus HE, Wheeler R. The morbidity and mortality of vermiculite miners and millers exposed to tremolite-actinolite: part II. Mortality. Am J Ind Med (1987) 11:15–26.[Web of Science][Medline]
26. Enterline PE, Hartley J, Henderson V. Asbestos and cancer: a cohort followed up to death. Br J Ind Med (1987) 44:396–401.[Web of Science][Medline]
27. Armstrong BK, de Klerk NH, Musk AW, et al. Mortality in miners and millers of crocidolite in Western Australia. Br J Ind Med (1988) 45:5–13.[Web of Science][Medline]
28. Neuberger M, Kundi M. Individual asbestos exposure: smoking and mortality—a cohort study in the asbestos cement industry. Br J Ind Med (1990) 47:615–620.[Web of Science][Medline]
29. Selikoff IJ, Seidman H. Asbestos-associated deaths among insulation workers in the United States and Canada, 1967 –1987. Ann N Y Acad Sci (1991) 643:1–14.[Web of Science][Medline]
30. Sanden A, Jarvholm B, Larsson S, et al. The risk of lung cancer and mesothelioma after cessation of asbestos exposure: a prospective cohort study of shipyard workers. Eur Respir J (1992) 5:281–285.[Abstract]
31. Sluis-Cremer GK, Liddell FD, Logan WP, et al. The mortality of amphibole miners in South Africa, 1946 –80. Br J Ind Med (1992) 49:566–575.[Web of Science][Medline]
32. Menegozzo M, Belli S, Bruno C, et al. Mortality due to causes correlatable to asbestos in a cohort of workers in railway car construction. Med Lav (1993) 84:193–200.[Medline]
33. Dement JM, Brown DP, Okun A. Follow-up study of chrysotile asbestos textile workers: cohort mortality and case-control analyses. Am J Ind Med (1994) 26:431–447.[Web of Science][Medline]
34. Meurman LO, Pukkala E, Hakama M. Incidence of cancer among anthophyllite asbestos miners in Finland. Occup Environ Med (1994) 51:421–425.
35. Magnani C, Terracini B, Ivaldi C, et al. Tumor mortality and from other causes in asbestos cement workers at the Casale Montferrato plant. Med Lav (1996) 87:133–146.[Medline]
36. Germani D, Belli S, Bruno G, et al. Cohort mortality study of women compensated for asbestosis in Italy. Am J Ind Med (1999) 36:129–134.[CrossRef][Web of Science][Medline]
37. Tulchinsky TH, Ginsberg GM, Iscovich J, et al. Cancer in ex-asbestos cement workers in Israel, 1953 –1992. Am J Ind Med (1999) 35:1–8.[CrossRef][Web of Science][Medline]
38. Yano E, Wang ZM, Wang XR, et al. Cancer mortality among workers exposed to amphibole-free chrysotile asbestos. Am J Epidemiol (2001) 154:538–543.
39. Szeszenia-Dabrowska N, Urszula W, Szymczak W, et al. Mortality study of workers compensated for asbestosis in Poland, 1970 –1997. Int J Occup Med Environ Health (2002) 15:267–278.[Medline]
40. Ulvestad B, Kjaerheim K, Martinsen JI, et al. Cancer incidence among workers in the asbestos-cement producing industry in Norway. Scand J Work Environ Health (2002) 28:411–417.[Web of Science][Medline]
41. Hodgson JT, Darnton A. The quantitative risks of mesothelioma and lung cancer in relation to asbestos exposure. Ann Occup Hyg (2000) 44:565–601.
42. Coggon D, Inskip H, Winter P, et al. Differences in occupational mortality from pleural cancer, peritoneal cancer, and asbestosis. Occup Environ Med (1995) 52:775–777.
43. Cocco P, Dosemeci M. Peritoneal cancer and occupational exposure to asbestos: results from the application of a job-exposure matrix. Am J Ind Med (1999) 35:9–14.[CrossRef][Web of Science][Medline]
44. Spirtas R, Heineman EF, Bernstein L, et al. Malignant mesothelioma: attributable risk of asbestos exposure. Occup Environ Med (1994) 51:804–811.
45. Newhouse ML, Thompson H. Mesothelioma of pleura and peritoneum following exposure to asbestos in the London area. 1965. Br J Ind Med (1993) 50:769–778.[Web of Science][Medline]
46. Vianna NJ, Polan AK. Non-occupational exposure to asbestos and malignant mesothelioma in females. Lancet (1978) i:1061–1063.
47. International Agency for Research on Cancer. Silica and Some Silicates. IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans (1997) Volume 42. Lyon, France: IARC. 225.[Medline]
48. Baris YI, Saracci R, Simonato L, et al. Malignant mesothelioma and radiological chest abnormalities in two villages in Central Turkey. An epidemiological and environmental investigation. Lancet (1981) i:984–987.
49. Saracci R, Simonato L, Baris Y, et al. The age-mortality curve of endemic pleural mesothelioma in Karain, Central Turkey. Br J Cancer (1982) 45:147–149.[Web of Science][Medline]
50. Baris YI, Simonato L, Artvinli M, et al. Epidemiological and environmental evidence of the health effects of exposure to erionite fibres: a four-year study in the Cappadocian region of Turkey. Int J Cancer (1987) 39:10–17.[Web of Science][Medline]
51. Metintas M, Hillerdal G, Metintas S. Malignant mesothelioma due to environmental exposure to erionite: follow-up of a Turkish emigrant cohort. Eur Respir J (1999) 13:523–526.[Abstract]
52. International Agency for Research on Cancer. Man-Made Vitreous Fibres. In: IARC Monographs on the Evaluation of The Carcinogenic Risks to Humans (2002) Volume 81. Lyon, France: IARC.
53. Andersson M, Wallin H, Jonsson M, et al. Lung carcinoma and malignant mesothelioma in patients exposed to Thorotrast: incidence, histology and p53 status. Int J Cancer (1995) 63:330–336.[CrossRef][Web of Science][Medline]
54. Van Kaick G, Dalheimer A, Hornik S, et al. The German thorotrast study: recent results and assessment of risks. Radiat Res (1999) 152(Suppl):S64–S71.[CrossRef][Web of Science][Medline]
55. Ishikawa Y, Mori T, Machinami R. Lack of apparent excess of malignant mesothelioma but increased overall malignancies of peritoneal cavity in Japanese autopsies with Thorotrast injection into blood vessels. J Cancer Res Clin Oncol (1995) 121:567–570.[CrossRef][Web of Science][Medline]
56. Nyberg U, Nilsson B, Travis LB, et al. Cancer incidence among Swedish patients exposed to radioactive thorotrast: a forty-year follow-up survey. Radiat Res (2002) 157:419–425.[CrossRef][Web of Science][Medline]
57. Dos Santos Silva I, Malveiro F, Jones ME, et al. Mortality after radiological investigation with radioactive Thorotrast: a follow-up study of up to fifty years in Portugal. Radiat Res (2003) 159:521–534.[CrossRef][Web of Science][Medline]
58. Travis LB, Hauptmann M, Gaul LK, et al. Site-specific cancer incidence and mortality after cerebral angiography with radioactive thortrast. Radiat Res (2003) 160:691–706.[CrossRef][Web of Science][Medline]
59. Gilks B, Hegedus C, Freeman H, et al. Malignant peritoneal mesothelioma after remote abdominal radiation. Cancer (1988) 61:2019–2021.[CrossRef][Web of Science][Medline]
60. Gazdar AF, Butel JS, Carbone M. SV40 and human tumours: myth, association or causality? Nat Rev Cancer (2002) 2:957–964.[CrossRef][Web of Science][Medline]
61. Klein G, Powers A, Croce C. Association of SV40 with human tumors. Oncogene (2002) 21:1141–1149.[CrossRef][Web of Science][Medline]
62. López-Ríos F, Illei BP, Rusch V, et al. Evidence against a role for SV40 infection in human mesotheliomas and high risk of false-positive PCR results owing to presence of SV40 sequences in common laboratory plasmids. Lancet (2004) 364:1157–1166.[CrossRef][Web of Science][Medline]
63. Shivapurkar N, Wiethege T, Wistuba II, et al. Presence of simian virus 40 sequences in malignant pleural, peritoneal and noninvasive mesotheliomas. Int J Cancer (2000) 85:743–745.[CrossRef][Web of Science][Medline]
64. Peterson JT Jr, Greenberg SD, Buffler PA. Non-asbestos-related malignant mesothelioma. A review. Cancer (1984) 54:951–960.[CrossRef][Web of Science][Medline]
65. Carbone M, Kratzke RA, Testa JR. The pathogenesis of mesothelioma. Semin Oncol (2002) 29:2–17.[Web of Science][Medline]
66. Heineman EF, Bernstein L, Stark AD, et al. Mesothelioma, asbestos, and reported history of cancer in first-degree relatives. Cancer (1996) 77:549–554.[CrossRef][Web of Science][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  V. de Pangher Manzini, L. Recchia, M. Cafferata, C. Porta, S. Siena, L. Giannetta, F. Morelli, F. Oniga, A. Bearz, V. Torri, et al. Malignant peritoneal mesothelioma: a multicenter study on 81 cases Ann. Onc., July 27, 2009; (2009) mdp307v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A-H Harding, A Darnton, J Wegerdt, and D McElvenny Mortality among British asbestos workers undergoing regular medical examinations (1971-2005) Occup. Environ. Med., July 1, 2009; 66(7): 487 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W Riley BelmontTM Hyperthermia Pump in the conduct of intra-operative heated chemotherapy Perfusion, March 1, 2009; 24(2): 115 - 118. [Abstract] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||