Effect of Asbestos Exposure on the Frequency of EGFR Mutations and ALK/ROS1 Rearrangements in Patients With Lung Adenocarcinoma: A Multicentric Study

J Occup Environ Med. 2021 Mar 1;63(3):238-243. doi: 10.1097/JOM.0000000000002115.


Objective: The aim of this study is to investigate the effect of asbestos exposure on cancer-driver mutations.

Methods: Between January 2014 and September 2018, epidermal growth factor receptor (EGFR), anaplastic lymphoma receptor tyrosine kinase (ALK), and c-ros oncogene 1 receptor tyrosine kinase gene (ROS1) alterations, demographic characteristics, asbestos exposure, and asbestos-related radiological findings of 1904 patients with lung adenocarcinoma were recorded.

Results: The frequencies of EGFR mutations, ALK, and ROS1 rearrangements were 14.5%, 3.7%, and 0.9%, respectively. The rates of EGFR mutations and ALK rearrangements were more frequent in asbestos exposed non-smokers (48.7% and 9%, respectively). EGFR mutation rate was correlated to female gender and not-smoking, ALK rearrangement rate was correlated to younger age, not-smoking, and a history of asbestos exposure.

Conclusions: The higher rate of ALK rearrangements in asbestos-exposed lung adenocarcinoma cases shows that asbestos exposure may most likely cause genetic alterations that drive pulmonary adenocarcinogenesis.

Publication types

  • Multicenter Study

MeSH terms

  • Adenocarcinoma of Lung* / genetics
  • Anaplastic Lymphoma Kinase / genetics
  • Asbestos*
  • ErbB Receptors / genetics
  • Female
  • Humans
  • Lung Neoplasms* / genetics
  • Mutation
  • Oncogenes
  • Protein-Tyrosine Kinases / genetics
  • Proto-Oncogene Proteins / genetics


  • Proto-Oncogene Proteins
  • Asbestos
  • Anaplastic Lymphoma Kinase
  • EGFR protein, human
  • ErbB Receptors
  • Protein-Tyrosine Kinases
  • ROS1 protein, human