A new abstract on pleural plaques and subsequent lung cancers. Longer term studies do matter. So do more CT scans.
Am J Respir Crit Care Med. First published online 10 Nov 2014 as DOI: 10.1164/rccm.201406-1074OC Asbestos Exposure, Pleural Plaques and the Risk of Death from Lung Cancer Jean-Claude Pairon , Pascal Andujar , Mickael Rinaldo , Jacques Ameille , Patrick Brochard , Soizick Chamming’s , Bénédicte Clin , Gilbert Ferretti , Antoine Gislard , François Laurent , Amandine Luc , Pascal Wild , and Christophe Paris + Author Information. Corresponding Author: Jean-Claude Pairon, Email: jc.pairon@chicreteil.fr
Abstract Rationale: Although asbestos is a well-known lung carcinogen, the association between pleural plaques and lung cancer remains controversial. Objective: The present study was designed to examine this association among asbestos-exposed workers. Methods and measurements: An 6-year follow-up was conducted to study lung cancer mortality in the 5,402 male subjects participating in an asbestos-related diseases screening program organized between October 2003 and December 2005 in four French regions. Chest computed tomography (CT) scan was performed in all subjects with randomized, independent, double reading of CT scans focusing on benign asbestos-related abnormalities. Survival regression based on the Cox model was used to model lung cancer mortality according to the presence of pleural plaques, with age as the main time variable adjusting for smoking and cumulative exposure index to asbestos. All statistical tests were two-sided. Main results: Thirty-six deaths from lung cancer were recorded. Lung cancer mortality was significantly associated with pleural plaques in the follow-up study in terms of both the unadjusted hazard ratio (HR) = 2.91 [95% confidence interval (CI) = 1.49 to 5.70 and the adjusted HR = 2.41 [95%CI = 1.21-4.85] after adjustment for smoking and cumulative exposure index to asbestos. Conclusions: The presence of pleural plaques may be an independent risk factor for lung cancer death in asbestos-exposed workers and could be used as an additional criterion in the definition of high-risk populations eligible for CT screening. Read More: http://www.atsjournals.org/doi/abs/10.1164/rccm.201406-1074OC#.VGUA-1fF9Ia