{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:25:05Z","timestamp":1790393105972,"version":"4.1.0"},"reference-count":38,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2019,9,15]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Asbestos exposure is associated with mesothelioma and cancer of the lung, larynx and ovary. However, the association between asbestos exposure and colorectal cancer is controversial despite several systematic reviews of the literature, including a number of meta-analyses. We performed a systematic review and meta-analysis to evaluate quantitatively the association between exposure to asbestos and colorectal cancer. We searched for articles on occupational asbestos exposure and colorectal cancer in PubMed, EMBASE and Web of Science published before April 2018. In total, 44 articles were selected and 46 cohort studies were analysed. The overall pooled risk estimates and corresponding 95% CIs of the association between occupational asbestos exposure and colorectal cancer were calculated using a random-effects model. Subgroup analyses and sensitivity tests were also performed. There was a significantly increased risk of colorectal cancer mortality among workers exposed to asbestos occupationally, with an overall pooled SMR of 1.16 (95% CI: 1.05 to 1.29). The pooled SMR for colorectal cancer was elevated in studies in which the asbestos-associated risk of lung cancer was also elevated (1.43; 95% CI: 1.30 to 1.56). This implies that the risk of colorectal cancer mortality increases as the level of asbestos exposure rises. A sensitivity analysis showed robust results and there was no publication bias. Although the effect size was small and the heterogeneity among studies was large, our findings indicate that occupational exposure to asbestos is a risk factor for colorectal cancer.<\/jats:p>","DOI":"10.1136\/oemed-2019-105735","type":"journal-article","created":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T17:15:14Z","timestamp":1570554914000},"page":"861-871","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Exposure to asbestos and the risk of colorectal cancer mortality: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6296-8058","authenticated-orcid":false,"given":"Kyeongmin","family":"Kwak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-6362","authenticated-orcid":false,"given":"Domyung","family":"Paek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2821-070X","authenticated-orcid":false,"given":"Kyung Ehi","family":"Zoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,8]]},"reference":[{"key":"2024110804100652000_76.11.861.1","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1289\/EHP153","article-title":"Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the asbestos-related diseases cohort (ARDCo-Nut)","volume":"125","author":"Paris","year":"2017","journal-title":"Environ Health Perspect"},{"key":"2024110804100652000_76.11.861.2","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1093\/oxfordjournals.aje.a116967","article-title":"A meta-analysis of colorectal cancer and asbestos exposure","volume":"139","author":"Homa","year":"1994","journal-title":"Am J Epidemiol"},{"key":"2024110804100652000_76.11.861.3","unstructured":"Institute of Medicine . Asbestos: selected cancers. Washington, DC: The National Academies Press, 2006: 216\u201329."},{"key":"2024110804100652000_76.11.861.4","doi-asserted-by":"crossref","first-page":"S124","DOI":"10.1016\/j.yrtph.2007.10.009","article-title":"Risk of gastrointestinal cancers from inhalation and ingestion of asbestos","volume":"52(1 Suppl)","author":"Gamble","year":"2008","journal-title":"Regul Toxicol Pharmacol"},{"key":"2024110804100652000_76.11.861.5","first-page":"219","volume-title":"A review of human carcinogens. Part C: arsenic, metals, fibres, and dust","volume":"100","year":"2012"},{"key":"2024110804100652000_76.11.861.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2024110804100652000_76.11.861.7","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj252"},{"key":"2024110804100652000_76.11.861.8","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"2024110804100652000_76.11.861.9","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1080\/10937404.2016.1195319","article-title":"Tyler asbestos workers: a mortality update in a cohort exposed to amosite","volume":"19","author":"Levin","year":"2016","journal-title":"J Toxicol Environ Health B Crit Rev"},{"key":"2024110804100652000_76.11.861.10","doi-asserted-by":"publisher","DOI":"10.1136\/oem.37.1.11"},{"key":"2024110804100652000_76.11.861.11","doi-asserted-by":"publisher","DOI":"10.1136\/oem.50.12.1073"},{"key":"2024110804100652000_76.11.861.12","doi-asserted-by":"publisher","DOI":"10.1093\/annhyg\/29.3.305"},{"key":"2024110804100652000_76.11.861.13","doi-asserted-by":"publisher","DOI":"10.1007\/BF00405785"},{"key":"2024110804100652000_76.11.861.14","doi-asserted-by":"publisher","DOI":"10.1136\/oem.34.3.174"},{"key":"2024110804100652000_76.11.861.15","doi-asserted-by":"crossref","unstructured":"Smith DD . The health effects of asbestos: an evidence-based approach. Boca Raton, FL: CRC Press, 2015: 146\u201363.","DOI":"10.1201\/b19413"},{"key":"2024110804100652000_76.11.861.16","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1003283"},{"key":"2024110804100652000_76.11.861.17","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2014-102178"},{"key":"2024110804100652000_76.11.861.18","doi-asserted-by":"crossref","first-page":"447","DOI":"10.2188\/jea.JE20150233","article-title":"Risk of lung cancer in workers exposed to benzidine and\/or beta-naphthylamine: a systematic review and meta-analysis","volume":"26","author":"Tomioka","year":"2016","journal-title":"J Epidemiol"},{"key":"2024110804100652000_76.11.861.19","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1289\/ehp.941021038","article-title":"Asbestos and colon cancer: a weight-of-the-evidence review","volume":"102","author":"Gamble","year":"1994","journal-title":"Environ Health Perspect"},{"key":"2024110804100652000_76.11.861.20","doi-asserted-by":"publisher","DOI":"10.1080\/10408440802272158"},{"key":"2024110804100652000_76.11.861.21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4251\/wjgo.v3.i3.33","article-title":"Epidemiology of cancer of the small intestine","volume":"3","author":"Pan","year":"2011","journal-title":"World J Gastrointest Oncol"},{"key":"2024110804100652000_76.11.861.22","first-page":"60","article-title":"Asbestos and gastrointestinal cancer. A review of the literature","volume":"143","author":"Morgan","year":"1985","journal-title":"West J Med"},{"key":"2024110804100652000_76.11.861.23","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1016\/0016-5085(90)90984-9","article-title":"Asbestos and colorectal cancer","volume":"99","author":"Weiss","year":"1990","journal-title":"Gastroenterology"},{"key":"2024110804100652000_76.11.861.24","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1097\/00043764-199512000-00006","article-title":"The lack of causality between asbestos and colorectal cancer","volume":"37","author":"Weiss","year":"1995","journal-title":"J Occup Environ Med"},{"key":"2024110804100652000_76.11.861.25","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008980927434"},{"key":"2024110804100652000_76.11.861.26","doi-asserted-by":"publisher","DOI":"10.1126\/science.219478"},{"key":"2024110804100652000_76.11.861.27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1985.03360200084033"},{"key":"2024110804100652000_76.11.861.28","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700190507"},{"key":"2024110804100652000_76.11.861.29","unstructured":"Chouroulinkov I . Experimental studies on ingested fibres. IARC Sci Publ 1989;(90):112\u201326."},{"key":"2024110804100652000_76.11.861.30","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(78)90078-4"},{"key":"2024110804100652000_76.11.861.31","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1289\/ehp.8353121","article-title":"Review of published studies on gut penetration by ingested asbestos fibers","volume":"53","author":"Cook","year":"1983","journal-title":"Environ Health Perspect"},{"key":"2024110804100652000_76.11.861.32","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1054\/mehy.2000.1049","article-title":"Asbestos fibres in drinking water: are they carcinogenic or not?","volume":"55","author":"Varga","year":"2000","journal-title":"Med Hypotheses"},{"key":"2024110804100652000_76.11.861.33","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19800315)45:5+<1073::AID-CNCR2820451308>3.0.CO;2-W"},{"key":"2024110804100652000_76.11.861.34","first-page":"301","article-title":"Ingested asbestos and intestinal carcinogenesis in F344 rats","volume":"3","author":"Ward","year":"1980","journal-title":"J Environ Pathol Toxicol"},{"key":"2024110804100652000_76.11.861.35","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s10552-004-7844-1","article-title":"Cancer of the gastrointestinal tract and exposure to asbestos in drinking water among lighthouse keepers (Norway)","volume":"16","author":"Kj\u00e6rheim","year":"2005","journal-title":"Cancer Causes Control"},{"key":"2024110804100652000_76.11.861.36","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1080\/17474124.2017.1300528","article-title":"Asbestos ingestion and gastrointestinal cancer: a possible underestimated hazard","volume":"11","author":"Di Ciaula","year":"2017","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"2024110804100652000_76.11.861.37","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1002\/ajim.22242","article-title":"Utility of death certificate data in predicting cancer incidence","volume":"57","author":"Bedford","year":"2014","journal-title":"Am J Ind Med"},{"key":"2024110804100652000_76.11.861.38","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2019-105735","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T12:11:32Z","timestamp":1731067892000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2019-105735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,8]]},"references-count":38,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,10,14]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/oemed-2019-105735"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2019-105735","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,8]]}}}