Update on lung cancer and mesothelioma

Our plain-English summary of Update on lung cancer and mesothelioma, by J.S. Brown, S.G. Spiro (Journal of the Royal College of Physicians of London, 1999).

The study

• Authors: J.S. Brown, S.G. Spiro
• Journal: Journal of the Royal College of Physicians of London
• Published: 1999;33(6):506-12
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Free full text

In plain English

This article was a short continuing medical education review of lung cancer and malignant mesothelioma. It reported no new study and summarised published work. On mesothelioma, the authors wrote that most cases result from occupational exposure to asbestos, which was used widely up to 1970. Using a 1995 study of mesothelioma deaths in Britain, they listed occupations by level of risk. Metal plate workers and shipbuilders, vehicle body builders, and plumbers and gas fitters were in the highest group, with proportional mortality ratios above 400 among men aged 16-74 in England and Wales in 1979-1980 and 1982-1990. They noted a time lag of more than 30 years between exposure and disease and a predicted peak of 2,700-3,300 cases per year around 2020. They added that low-level exposure of a large population, such as residents near an asbestos factory, can produce a significant number of cases. They reported a five-year survival below 5% and no conclusive benefit from chemotherapy, immunotherapy or gene therapy. The lung cancer sections covered incidence, staging, surgery, radiotherapy, chemotherapy and the organisation of services.

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: Narrative clinical review (continuing medical education update) summarising published studies and guidelines; no original data collected
• Who was studied: No study population of its own; a review of published work on lung cancer and malignant mesothelioma, mainly in the UK
• Exposure: For mesothelioma: occupational exposure to asbestos (fiber types not specified), which the authors said was used widely up to 1970; occupations at risk were listed from a cited study of men aged 16-74 in England and Wales
• Main results:
  • In a table adapted from a cited study (Peto et al., 1995), the occupations at high risk of mesothelioma due to asbestos exposure (proportional mortality ratio above 400, men aged 16-74 in England and Wales, 1979-1980 and 1982-1990) were metal plate workers/shipbuilders, vehicle body builders, and plumbers and gas fitters
  • The authors described a time lag of more than 30 years between exposure and developing mesothelioma
  • Citing the same 1995 study, the predicted incidence of mesothelioma in Britain will peak at 2,700-3,300 cases per year around 2020 and then rapidly fall
  • The authors wrote that low-level exposure of a large population, such as residents living near an asbestos factory, can result in a significant number of cases
  • Mesothelioma: distant metastases are present at post-mortem in 50% of patients
  • Mesothelioma: chemotherapy regimens, immunotherapy with cytokines and gene therapy have been used with no conclusive benefits; five-year survival is less than 5%
  • Lung cancer causes approximately 35,000 deaths per year in the UK
  • Lung cancer: a cited randomised trial found that continuous hyperfractionated accelerated radiotherapy (CHART) improved two-year survival from 20% to 29% compared with conventional radical radiotherapy
• The authors' conclusion: Among the authors' key points: the incidence of mesothelioma will peak around 2020 before rapidly falling, and any patient with pleural thickening or effusions on chest X-ray who has been exposed to asbestos requires thorough assessment by a chest physician

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma.

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