Review Question - QID 100904

Asbestos and cigarette smoking are both causative agents for bronchogenic carcinoma (lung cancer).

Inhalation of asbestos fibers may lead to a number of respiratory diseases, including lung cancer, asbestosis, pleural plaques, benign pleural effusion, and malignant mesothelioma. Smoking is a risk factor for most types of lung cancer, COPD, hypertension, stroke, and a host of other diseases. Smokers with a history of asbestos exposure have a 90-fold increase in the risk of bronchogenic carcinoma.

O'Reilly et al. emphasize that the treatment of patients with asbestos exposure and lung cancer is identical to that of any patient with lung cancer. Because exposure to cigarette smoke increases the risk of developing lung cancer in patients with a history of asbestos exposure, smoking cessation is essential.

Kamp et al. describe the epidemiology and molecular biology of asbestos-induced lung diseases. They report that despite a dramatic reduction in asbestos use worldwide, asbestos-induced lung diseases remain a substantial health concern, primarily because of the vast amounts of fibers that have been mined, processed, and used during the 20th century combined with the long latency period of up to 40 years between exposure and disease presentation.

Illustration A shows the histology of a small cell lung carcinoma which is commonly caused by smoking and asbestos exposure.

Incorrect Answers:
Answer 1-2: While smoking has been definitely linked to COPD, the role of asbestos is still unclear in chronic bronchitis and emphysema, and so this is not the best answer.
Answer 3: Smoking has been linked to multiple myeloma, but asbestos exposure has not.
Answer 4: Asbestos exposure leads to an increased incidence of pulmonary mesothelioma; smoking does not.