Open AccessRelationship between exposure to ionizing radiation and mesothelioma risk: A systematic review of the scientific literature and meta‐analysis
Author(s) -
Visci Giovanni,
Rizzello Emanuele,
Zunarelli Carlotta,
Violante Francesco Saverio,
Boffetta Paolo
Publication year - 2022
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.4436
Subject(s) - meta analysis , medicine , mesothelioma , funnel plot , relative risk , ionizing radiation , publication bias , population , confidence interval , scopus , incidence (geometry) , environmental health , medline , pathology , biology , irradiation , biochemistry , physics , nuclear physics , optics
Background Ionizing radiation and mesothelioma have been examined among personnel employed in nuclear power plant and patients treated by external beam radiation therapy (EBRT). The association is still controversial; the purpose of this review is to summarize the scientific evidence published in the literature regarding the relationship between ionizing radiation and incidence of mesothelioma and, if possible, estimating strongness of the association by meta‐analysis of extracted data. Methods Articles included in the systematic review were retrieved by searching among the three main scientific databases: PubMed, Scopus, and Embase. The literature search was conducted in June 2021. A meta‐analysis of random effects was conducted, stratified by exposure (EBRT, occupational exposure). The heterogeneity of the summary relative risks (RRs) was assessed using I 2 statistics. Publication bias was evaluated graphically through the funnel plot. Findings The exposure to ionizing radiation could be a risk factor for mesothelioma: both for exposure to high doses for short periods (EBRT) (RR of 3.34 [95% confidence interval, CI 1.24–8.99]) and for exposure to low doses for a prolonged duration (exposure working) (RR of 3.57 [95% CI 2.16–5.89]). Conclusions Despite the low number of mesotheliomas in the general population, the steadily increased risk among individuals exposed to radiation is still worth considering.