Asbestosis and carcinoma of the lung

Our plain-English summary of Asbestosis and carcinoma of the lung, by J. F. Cordova, H. Tesluk, K. P. Knudtson (1962).

The study

• Authors: J. F. Cordova, H. Tesluk, K. P. Knudtson
• Published: Cancer, vol. 15, 1962 (J. B. Lippincott Company)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article was a case series in which the authors described 11 men who had both asbestosis and lung carcinoma. Six came from the authors' own surgical and autopsy material at three Seattle, Washington institutions, and five came from the files of the Armed Forces Institute of Pathology. The patients' jobs included insulation work, asbestos plant work, shipyard work, bricklaying and carpentry. The article did not name specific asbestos fiber types. Ten patients were white and one was described as Negro. The tumors occurred most often in the right upper lobe (6 cases), and no single cell type predominated. At least 2 cases showed evidence that the tumor arose in more than one place. Five patients had smoked cigarettes for 20 years or longer. Four patients had no known history of direct asbestos exposure. In those four, asbestosis was diagnosed only from lung scarring with asbestos bodies seen under the microscope. The authors discussed a possible link between asbestos and lung cancer. They wrote that, if these cases are accepted as asbestosis, the patients must have been exposed to asbestos dust in some form.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series (11 case reports) drawn from hospital surgical, autopsy and institute files, with a discussion of earlier published studies
• Who was studied: 11 male patients with asbestosis and lung cancer. Two came from Virginia Mason Hospital, two from the Seattle Veterans Administration Hospital and two from Firland Sanatorium, all in Seattle, Washington. Five came from the Armed Forces Institute of Pathology, Washington, D.C. Ten were white and one was described as Negro. Dates of the cases are not given.
• Exposure: Asbestos dust in various jobs: a hod carrier who worked with insulating material, an ironworker, a shipyard worker, a retired bricklayer, a pipe insulator and coverer, an asbestos plant worker, an asbestos insulator at Bremerton Naval Shipyard, a carpenter, an insulation worker who also handled Fiberglas, an asbestos handler, and one man exposed to asbestos and magnesium. No fiber type (such as chrysotile or amosite) is named. Most patients were also cigarette smokers.
• Main results:
  • Armed Forces Institute of Pathology: 5 lung cancer cases among 20 cases of asbestosis on file, which the authors gave as an incidence of 25%
  • Seattle Veterans Administration Hospital: 2 lung cancer cases among 6 cases of asbestosis. The percentage is printed illegibly in the scanned text.
  • Firland Sanatorium: 2 lung cancer cases from a total of 6 proved cases of asbestosis, given as an incidence of 33%
  • In this series, lung carcinoma occurred most often in the right upper lobe (6 cases), and five patients had smoked cigarettes for 20 years or longer
  • No cell type of lung carcinoma predominated in the series
  • Among the patients for whom it could be determined, the mean duration of asbestos exposure was 35 years. The number of patients this applies to is illegible in the text.
  • Death was most often attributed to bronchopneumonia, lung abscess and cor pulmonale
  • Four of the 11 patients had no known history of direct asbestos exposure. Their asbestosis diagnosis rested only on lung fibrosis with asbestos bodies seen on microscopic examination.
  • In at least 2 cases there was evidence that the tumor arose in more than one place (multifocal origin)
• The authors' conclusion: The authors presented the cases and discussed a possible relationship between asbestos and lung cancer. They wrote that, if the cases are accepted as asbestosis, the patients without known exposure must still have been exposed to asbestos dust in some form. They also wrote that the lack of known exposure in 4 cases indicates the disease can occur without prolonged exposure to known sources.
• Limitations the authors state:
  • In the 4 patients without a known exposure history, the asbestosis diagnosis was based entirely on microscopic findings. The authors framed their interpretation as conditional on accepting these cases as asbestosis.

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Autopsy, Pathology, Asbestos Exposure, Asbestos Bodies, Lung Cancer.

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