Contributors: Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE); Université de Caen Normandie (UNICAEN); Normandie Université (NU)-Normandie Université (NU)-CHU Caen Normandie – Centre Hospitalier Universitaire de Caen Normandie (CHU Caen Normandie); Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse Caen (UNICANCER/CRLC); Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM); Bordeaux population health (BPH); Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM); Cancer environnement (EPICENE); Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM); Centre Hospitalier Intercommunal de Créteil (CHIC); IMRB - GEIC2O/"Genetic and Environmental Interactions in COPD, Cystic fibrosis and Other (rare) respiratory diseases" Créteil (U955 Inserm - UPEC); Institut Mondor de Recherche Biomédicale (IMRB); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Centre Hospitalier Universitaire de Nancy (CHU Nancy); INterdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes (INSPIIRE); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL); CHU de Bordeaux Pellegrin Bordeaux; CHU Rouen; Normandie Université (NU); Université de Bordeaux (UB); Centre de recherche Cardio-Thoracique de Bordeaux Bordeaux (CRCTB); Université de Bordeaux (UB)-Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux)-Institut National de la Santé et de la Recherche Médicale (INSERM); Centre Hospitalier Universitaire Rennes; Institut de recherche en santé, environnement et travail (Irset); Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique EHESP (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes (Biosit : Biologie - Santé - Innovation Technologique); This work was supported by the French National Health Insurance (Occupational Risk Prevention Department), the French Ministry of Labour and Social Relations, the French Agency for Food, Environmental and Occupational Health & Safety (ANSES grant 07-CRD-51 and EST 2006/1/43 and EST 2009/68). Study sponsors played no role in study design (except for the choice of French regions in which the study was to be conducted), data collection, data analysis, data interpretation or drafting of the report. The corresponding author had final responsibility for the decision Funding information. Grant number: ANSES grant 07-CRD-51 and EST 2006/1/43 and EST 2009/68.
نبذة مختصرة : International audience ; Background: The aim of this study was to analyse the incidence and mortality from various digestive cancer sites and their potential link with pleural plaques, in a French cohort of workers previously occupationally exposed to asbestos.Methods: We conducted a 10-year follow-up study in 13,481 male subjects, included in the cohort between October 2003 and December 2005, for whom asbestos exposure was assessed by calculation of a cumulative exposure index (CEI) in equivalent fibres.years/mL for each subject. We conducted an incidence study and a mortality study. Complementary analysis was restricted to men who had performed at least one chest CT-scan (N = 4,794). We used a Cox model with age as the time axis variable, adjusted for smoking, time since first exposure (TSFE), CEI to asbestos and the existence of pleural plaques on CT-scan.Results: In the incidence study, a significant dose-response relationship was observed between CEI to asbestos and oesophageal cancer (HR 1.03, 95% CI [1.01-1.06]) in the entire cohort after adjustment for TSFE and smoking status. In subjects undergoing CT-scan, a significant association between pleural plaques was observed for oesophageal cancer incidence (HR 2.80, 95% CI [1.09-7.20]) and in the mortality study, multivariate analyses showed a significant dose-effect response between CEI to asbestos and death from oesophageal cancer (HR 1.03, 95% CI [1.00-1.05]) in the entire cohort.Conclusions: This large-scale study confirms results concerning a likely relationship between asbestos exposure and oesophageal cancer, and the association between this cancer and pleural plaques after adjustment on CEI to asbestos.
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