Environmental asbestos exposure and lung cancer burden compared with mesothelioma in rural Türkiye: A 33-Year population-based cohort study
Lung Cancer, cilt.220, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 220
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.lungcan.2026.109592
- Dergi Adı: Lung Cancer
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: Asbestos, Cohort Studies, Environmental Exposure, Lung Neoplasms, Mesothelioma, Mortality
- Eskişehir Osmangazi Üniversitesi Adresli: Evet
Özet
Background: Long-term environmental asbestos exposure remains an underrecognized cause of lung cancer (LC). We evaluated the impact of environmental asbestos exposure on LC mortality, temporal trends, years of life lost (YLL), and its relationship with malignant mesothelioma in a 33-year population-based cohort in rural Türkiye. Methods: This retrospective cohort included all LC and mesothelioma cases diagnosed between 1990 and 2022 in environmentally asbestos-exposed and adjacent non-exposed districts in Eskişehir region of Central Anatolia. Age-standardized mortality rates, Joinpoint trend analyses, relative risks (RRs), and YLL were calculated using person-year denominators. Results: The cohort comprised 1,223,765 exposed and 388,401 non-exposed person-years. Overall, 629 LC cases were identified in exposed districts and 46 in non-exposed districts, whereas 235 malignant mesothelioma cases occurred only in exposed districts. Environmental asbestos exposure increased LC mortality more than fourfold (RR, 4.11; 95% CI, 3.02–5.60). Age-standardized LC mortality rates were 71.5 and 8.8 per 100,000 person-years among exposed men and women, versus 19.0 and 0.85, respectively, in non-exposed populations. LC mortality increased over time (annual percentage change, 6.8% in men and 13.0% in women). LC mortality exceeded mesothelioma mortality 2.68-fold and accounted for greater YLL, whereas clinicopathological characteristics and survival were similar between groups. Conclusions: Long-term environmental asbestos exposure substantially increases LC mortality and premature mortality. Although mesothelioma remains the sentinel asbestos-related malignancy, LC represents the principal population-level consequence of environmental asbestos exposure. These findings support incorporating environmental asbestos exposure into risk assessment, surveillance, and low-dose computed tomography screening strategies in endemic regions.