Risk of mesothelioma after cessation of asbestos exposure: a systematic review and meta-regression

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.

Keywords: Asbestos; Mesothelioma; Time since last exposure.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Asbestos / toxicity*
  • Carcinogens, Environmental / adverse effects
  • Female
  • Humans
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / mortality
  • Male
  • Mesothelioma / epidemiology*
  • Mesothelioma / mortality
  • Occupational Exposure / adverse effects*
  • Peritoneal Neoplasms / epidemiology
  • Peritoneal Neoplasms / mortality
  • Pleural Neoplasms / epidemiology
  • Pleural Neoplasms / mortality
  • Risk Factors
  • Time Factors*


  • Carcinogens, Environmental
  • Asbestos