Cancer Of The Pancreas Among Asbestos Insulation Workers

Our plain-English summary of Cancer Of The Pancreas Among Asbestos Insulation Workers, by I.J. Selikoff, H. Seidman (1981).

The study

• Authors: I.J. Selikoff, H. Seidman
• Published: Cancer 47(6):1469-1473, March 15 (1981)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 000776. The article is still under copyright, so we describe it here rather than post it.

In plain English

This study followed 17,800 men in the asbestos insulation workers' union in the United States and Canada from January 1, 1967 to December 31, 1976. It compared their deaths with those expected from U.S. white male death rates. There were 2271 deaths against 1658.9 expected, and 995 cancer deaths against 319.7 expected. Death certificates listed cancer of the pancreas for 49 men, when 17.5 were expected. The authors then reviewed clinical, surgical and autopsy information. After that review, only 23 deaths were judged to be pancreatic cancer: 22 from those certificates and one listed as myocardial infarction. The other 27 certificate cases were found to be peritoneal mesothelioma (16), carcinomatosis with no primary site found (5), lung cancer (4) and colon cancer (2). Among men 20 or more years from first exposure who had smoked cigarettes, 10 pancreatic cancer deaths were observed against 11.2 expected, and no significant smoking-specific influence was found. The authors said they had not shown there is no increase and that some limited increase is possible. They added that detailed case review appears useful in judging pancreatic cancer risk.

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: Cohort mortality study of a union membership followed forward from 1967, comparing observed deaths (by death certificate and by best available evidence) with expected deaths
• Who was studied: 17,800 men on the rolls of the asbestos insulation workers' union in the United States and Canada on January 1, 1967, followed to December 31, 1976 (166,853 man-years); 12,051 of them reached 20 or more years from onset of work
• Exposure: Work as asbestos insulation workers, measured as years since first insulation work; smoking history was available for a majority of the men. The article does not name fiber types or give doses.
• Main results:
  • All 17,800 workers, 1967 to 1976: 2271 deaths observed against 1658.9 expected
  • All 17,800 workers: 995 cancer deaths observed against 319.7 expected
  • Cancer of the pancreas was listed on 49 death certificates, against 17.5 expected
  • After review of best available evidence, 23 deaths were cancer of the pancreas: 22 so listed on death certificates and one listed as myocardial infarction
  • 27 deaths certified as cancer of the pancreas were found to have other causes: lung cancer 4, peritoneal mesothelioma 16, colon cancer 2, and disseminated carcinomatosis with primary site not ascertained 5
  • The confirmed and reclassified groups were fairly comparable in duration from onset of employment and age at death, though those dying of peritoneal mesothelioma tended to be somewhat younger
  • Among the 12,051 workers 20 or more years from onset who had smoked cigarettes, 10 pancreatic cancer deaths were observed against 11.2 expected from American Cancer Society smoking-specific data; no significant smoking-specific influence was found
• The authors' conclusion: The authors concluded that relying on death certificates would have wrongly suggested a significant increase in pancreatic cancer. They also concluded that detailed case review appears useful when judging a suggested increased risk of pancreatic cancer, especially for agents that cause cancer at several sites that can be confused with the pancreas.
• Limitations the authors state:
  • The authors stated they had not established that there is no increased incidence of pancreatic cancer among asbestos workers, and that some limited increase is possible
  • The authors noted uncertainty in the expected rates, since some general-population deaths counted as pancreatic cancer may really have been other cancers
  • General-population deaths used for comparison were not verified the way the study deaths were

Topics

Medical terms in this study, explained in our Lexicon: Insulator, Death Certificate, Autopsy, Peritoneal Mesothelioma, Lung Cancer, Colorectal Cancer.

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