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Exposure to asbestos and the risk of colorectal cancer mortality: a systematic review and meta-analysis

机译：暴露于石棉和结直肠癌死亡的风险：系统审查和荟萃分析

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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.
机译：石棉暴露与肺，喉和卵巢的间皮瘤和癌症有关。然而，尽管对文献有几次系统的评价，包括许多元分析，但石棉暴露和结肠直肠癌之间的关联是有争议的。我们进行了系统审查和荟萃分析，以定量地评估暴露于石棉和结肠直肠癌之间的关联。我们在2018年4月之前搜索了关于职业石棉暴露和大肠梗癌的文章，在2018年4月之前发布的。总共选择了44篇文章，并分析了46项队列研究。使用随机效应模型计算职业石棉暴露和结肠直肠癌之间的关联的整体汇总风险估算和相应的95％CI。还进行了亚组分析和敏感性测试。在职业上暴露于石棉的工人面临的人工人员中的结直肠癌死亡风险显着增加，整体汇总的SMR为1.16（95％CI：1.05至1.29）。结肠直肠癌的汇集SMR升高，其中石棉相关肺癌的风险也升高（1.43; 95％CI：1.30至1.56）。这意味着随着石棉暴露的水平升高，结肠直肠癌死亡的风险增加。敏感性分析显示出稳健的结果，没有出版物偏见。虽然效果大小较小，但研究中的异质性大，我们的研究结果表明，职业暴露于石棉是结直肠癌的危险因素。

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