停止石棉暴露后患间皮瘤的风险：系统评价和荟萃回归分析。
Risk of mesothelioma after cessation of asbestos exposure: a systematic review and meta-regression.
机构信息
The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
出版信息
Int Arch Occup Environ Health. 2019 Oct;92(7):949-957. doi: 10.1007/s00420-019-01433-4. Epub 2019 Apr 15.
PURPOSE
A 'risk reversal' has been observed for several human carcinogens following cessation of exposure, but it is unclear whether it also exists for asbestos-related mesothelioma.
METHODS
We conducted a systematic review of the literature and identified nine studies that reported information on risk of mesothelioma after cessation of asbestos exposure, and performed a meta-regression based on random effects models. As comparison we analyzed results on lung cancer risk from four of these studies.
RESULTS
A total of six risk estimates from five studies were included in the meta-analysis. The summary relative risk (RR) of mesothelioma for 10-year interval since cessation of exposure was 1.02 [95% confidence interval (CI) 0.87-1.19; p-heterogeneity 0.01]. The corresponding RR of lung cancer was 0.91 (95% CI 0.84-0.98).
CONCLUSIONS
This analysis provides evidence that the risk of mesothelioma does not decrease after cessation of asbestos exposure, while lung cancer risk does.
目的
在停止接触几种人类致癌物后，观察到了“风险逆转”，但尚不清楚这是否也适用于与石棉相关的间皮瘤。
方法
我们对文献进行了系统综述，确定了九项报告了石棉暴露停止后间皮瘤风险信息的研究，并基于随机效应模型进行了荟萃回归分析。作为比较，我们分析了其中四项研究中关于肺癌风险的结果。
结果
荟萃分析纳入了五项研究中的六项风险估计值。暴露停止后 10 年的间皮瘤汇总相对风险（RR）为 1.02（95%置信区间（CI）0.87-1.19；p-异质性 0.01）。相应的肺癌 RR 为 0.91（95%CI 0.84-0.98）。
结论
这项分析提供了证据表明，石棉暴露停止后，间皮瘤的风险不会降低，而肺癌风险会降低。
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