Re: Frumkin H, Berlin J (1988): asbestos exposure and gastrointestinal malignancy: review and meta-analysis. Am J Ind Med 14: 79-85

Our plain-English summary of Re: Frumkin H, Berlin J (1988): asbestos exposure and gastrointestinal malignancy: review and meta-analysis. Am J Ind Med 14: 79-85, by H. Frumkin (American Journal of Industrial Medicine, 1988).

The study

• Author: H. Frumkin
• Journal: American Journal of Industrial Medicine
• Published: 1988;14(4):493
• Type of article: Letter
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item is a brief letter to the editor correcting a typographical error in the authors' 1988 review and meta-analysis of asbestos exposure and gastrointestinal cancer. The letter stated that the error significantly changed the meaning of the abstract's final sentence. The authors used a lung cancer standardized mortality ratio (SMR) of at least 200 as a sign of significant asbestos exposure. As printed, the abstract said such exposure was associated with an elevated gastrointestinal cancer SMR "for five or six end points examined." The corrected wording is "five of six." The supplied text also contains the original paper. In it, the authors pooled published English-language cohort studies of asbestos workers and used each cohort's lung cancer SMR as a stand-in for exposure. In the high-exposure cohorts, SMRs were elevated, with confidence intervals excluding 100, at every end point except esophagus. In the low-exposure cohorts, all SMRs were close to 100. The authors noted that confidence intervals for the pooled colorectal and total gastrointestinal cancer SMRs would tend to be more valid than those for gastric and esophageal cancer.

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: Letter to the editor (correction) of the authors' earlier review and meta-analysis of published cohort studies
• Who was studied: The letter itself studied no one. The original meta-analysis pooled all available English-language cohort studies of asbestos workers that reported deaths as an outcome, with observed and expected counts for gastrointestinal cancers. These included cement workers, insulators, miners and millers, textile workers, shipyard workers and other industrial workers.
• Exposure: Occupational asbestos exposure in the cohorts. Because few studies measured dose, the authors used each cohort's lung cancer SMR as a proxy for exposure, with a lung cancer SMR of 200 separating high from low exposure.
• Main results:
  • The correction: the abstract's final sentence should have said an elevated gastrointestinal cancer SMR was found for five of six end points, not "five or six end points".
  • Original abstract wording that the letter corrects.
  • In the original paper, within the high-exposure cohorts (lung cancer SMR above 200), pooled SMRs were elevated, with 95% confidence intervals excluding 100, at all end points except esophagus.
  • In the original paper, among the low-exposure cohorts, all pooled SMRs were close to 100.
  • In the original paper, among high-exposure cohorts in studies that considered latency, the pooled SMR point estimates were 147 for esophageal cancer, 146 for gastric cancer and 168 for colorectal cancer.
• The authors' conclusion: The letter states that the typographical error significantly changed the intended meaning of the abstract's final sentence, and it gives the corrected wording.
• Limitations the authors state:
  • The authors stated that the confidence intervals for the pooled colorectal and total gastrointestinal cancer SMRs will tend to be more valid than those for gastric and esophageal cancer.
  • Stratifying by fiber type and industry produced tables too sparse to be informative, so it was not pursued.
  • Differences in age structure between cohorts could not be corrected without age- or latency-specific data.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Meta-Analysis.

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• In vitro approaches for determining mechanisms of toxicity and carcinogenicity by asbestos in the gastrointestinal and respiratory tracts — B.T. Mossman (1983)
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