Stomach cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies

Br J Cancer. 2015 May 26;112(11):1805-15. doi: 10.1038/bjc.2014.599. Epub 2015 Apr 30.


Background: A recent Monographs Working Group of the International Agency for Research on Cancer concluded that there is limited evidence for a causal association between exposure to asbestos and stomach cancer.

Methods: We performed a meta-analysis to quantitatively evaluate this association. Random effects models were used to summarise the relative risks across studies. Sources of heterogeneity were explored through subgroup analyses and meta-regression.

Results: We identified 40 mortality cohort studies from 37 separate papers, and cancer incidence data were extracted for 15 separate cohorts from 14 papers. The overall meta-SMR for stomach cancer for total cohort was 1.15 (95% confidence interval 1.03-1.27), with heterogeneous results across studies. Statistically significant excesses were observed in North America and Australia but not in Europe, and for generic asbestos workers and insulators. Meta-SMRs were larger for cohorts reporting a SMR for lung cancer above 2 and cohort sizes below 1000.

Conclusions: Our results support the conclusion by IARC that exposure to asbestos is associated with a moderate increased risk of stomach cancer.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asbestos / toxicity*
  • Australia
  • Europe
  • Female
  • Humans
  • Male
  • Occupational Diseases / chemically induced
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / pathology
  • Occupational Exposure*
  • Risk Assessment
  • Stomach Neoplasms / chemically induced
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / pathology


  • Asbestos