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Occupational Asbestos Exposure and Incidence of Colon and Rectal Cancers in French Men: The Asbestos-Related Diseases Cohort (ARDCo-Nut).

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Title:	Occupational Asbestos Exposure and Incidence of Colon and Rectal Cancers in French Men: The Asbestos-Related Diseases Cohort (ARDCo-Nut).
Authors:	Luc, Amandine¹, Paris, Christophe^1,2, Thaon, Isabelle^1,2, Gislard, Antoine³, Galan, Pilar⁴, Hercberg, Serge⁴, Wild, Pascal⁵, Pairon, Jean-Claude^6,7,8,9, Andujar, Pascal^6,7,8,9, Herin, Fabrice¹⁰, Clin, Benedicte¹⁰, Lacourt, Aude¹⁰, Coureau, Gaelle¹⁰, Brochard, Patrick¹⁰, Chamming's, Soizick¹⁰
Source:	Environmental Health Perspectives. Mar2017, Vol. 125 Issue 3, p409-415. 7p. 1 Diagram, 4 Charts.
Subject Terms:	Asbestos, Smoking, *Environmental exposure, Occupational disease prevention, Age distribution, Confidence intervals, Colon tumors, Men's health, Probability theory, Questionnaires, Research funding, Rectum tumors, Occupational hazards, Relative medical risk, Disease incidence, Proportional hazards models, Data analysis software, Descriptive statistics, Early detection of cancer, Diagnosis, Tumor risk factors, Cancer risk factors
Geographic Terms:	France
Abstract:	BACKGROUND: The relationships between asbestos exposure and colorectal cancer remain controversial. OBJECTIVES: We examined the association between asbestos exposure and colorectal cancer incidence. METHODS: Volunteer retired workers previously exposed to asbestos were invited to participate in the French ARDCo screening program between 2003 and 2005. Additional data on risk factors for colorectal cancer were collected from the ARDCo-Nut subsample of 3,769 participants in 2011. Cases of colon and rectal cancer were ascertained each year through 2014 based on eligibility for free medical care following a cancer diagnosis. Survival regression based on the Cox model was used to estimate the relative risk of colon and rectal cancer separately, in relation to the time since first exposure (TSFE) and cumulative exposure index (CEI) to asbestos, and with adjustment for smoking in the overall cohort and for smoking, and certain risk factors for these cancers in the ARDCo-Nut subsample. RESULTS: Mean follow-up was 10.2 years among 14,515 men, including 181 colon cancer and 62 rectal cancer cases (41 and 17, respectively, in the ARDCo-Nut subsample). In the overall cohort, after adjusting for smoking, colon cancer was significantly associated with cumulative exposure (HR = 1.14; 95% CI: 1.04, 1.26 for a 1-unit increase in ln-CEI) and ≥ 20-40 years since first exposure (HR = 4.67; 95% CI: 1.92, 11.46 vs. 0-20 years TSFE), and inversely associated with 60 years TSFE (HR = 0.26; 95% CI: 0.10, 0.70). Although rectal cancer was also associated with TSFE 20-40 years (HR = 4.57; 95% CI: 1.14, 18.27), it was not associated with ln-CEI, but these findings must be interpreted cautiously due to the small number of cases. CONCLUSIONS: Our findings provide support for an association between occupational exposure to asbestos and colon cancer incidence in men. CITATION: Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, Coureau G, Brochard P, Chamming's S, Gislard A, Galan P, Hercberg S, Wild P, Pairon JC, Andujar P. 2017. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos-Related Diseases Cohort (ARDCo-Nut). Environ Health Perspect 125:409-45; http://dx.doi. org/10.1289/EHP153 [ABSTRACT FROM AUTHOR]
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Abstract:	BACKGROUND: The relationships between asbestos exposure and colorectal cancer remain controversial. OBJECTIVES: We examined the association between asbestos exposure and colorectal cancer incidence. METHODS: Volunteer retired workers previously exposed to asbestos were invited to participate in the French ARDCo screening program between 2003 and 2005. Additional data on risk factors for colorectal cancer were collected from the ARDCo-Nut subsample of 3,769 participants in 2011. Cases of colon and rectal cancer were ascertained each year through 2014 based on eligibility for free medical care following a cancer diagnosis. Survival regression based on the Cox model was used to estimate the relative risk of colon and rectal cancer separately, in relation to the time since first exposure (TSFE) and cumulative exposure index (CEI) to asbestos, and with adjustment for smoking in the overall cohort and for smoking, and certain risk factors for these cancers in the ARDCo-Nut subsample. RESULTS: Mean follow-up was 10.2 years among 14,515 men, including 181 colon cancer and 62 rectal cancer cases (41 and 17, respectively, in the ARDCo-Nut subsample). In the overall cohort, after adjusting for smoking, colon cancer was significantly associated with cumulative exposure (HR = 1.14; 95% CI: 1.04, 1.26 for a 1-unit increase in ln-CEI) and ≥ 20-40 years since first exposure (HR = 4.67; 95% CI: 1.92, 11.46 vs. 0-20 years TSFE), and inversely associated with 60 years TSFE (HR = 0.26; 95% CI: 0.10, 0.70). Although rectal cancer was also associated with TSFE 20-40 years (HR = 4.57; 95% CI: 1.14, 18.27), it was not associated with ln-CEI, but these findings must be interpreted cautiously due to the small number of cases. CONCLUSIONS: Our findings provide support for an association between occupational exposure to asbestos and colon cancer incidence in men. CITATION: Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, Coureau G, Brochard P, Chamming's S, Gislard A, Galan P, Hercberg S, Wild P, Pairon JC, Andujar P. 2017. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos-Related Diseases Cohort (ARDCo-Nut). Environ Health Perspect 125:409-45; http://dx.doi. org/10.1289/EHP153 [ABSTRACT FROM AUTHOR]
ISSN:	00916765
DOI:	10.1289/EHP153