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{{Mesothelioma}}
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==Overview==
==Overview==
The most common cause of mesothelioma is asbestos-fibre exposure. Less common causes of mesothelioma include erionite-fibre exposure, Simian virus 40, and radiation exposure.<ref>Mesothelioma. Radiopaedia. http://radiopaedia.org/articles/mesothelioma. Accessed on 13th January, 2016. http://radiopaedia.org/articles/mesothelioma</ref>
Common causes of mesothelioma include [[asbestos|asbestos-fibre exposure]], erionite-fibre exposure, [[SV40|Simian virus 40]], [[radiation|radiation exposure]] and genetic predesposition<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref><ref name="pmid21874000" />
 
==Causes==
==Causes==
Mesothelioma is caused by:
Mesothelioma is caused by:<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref><ref name="pmid21874000">{{cite journal| author=Testa JR, Cheung M, Pei J, Below JE, Tan Y, Sementino E et al.| title=Germline BAP1 mutations predispose to malignant mesothelioma. | journal=Nat Genet | year= 2011 | volume= 43 | issue= 10 | pages= 1022-5 | pmid=21874000 | doi=10.1038/ng.912 | pmc=3184199 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21874000  }}</ref>
*Asbestos-fibre exposure: causes majority of cases
*[[asbestos|Asbestos-fibre exposure]]: causes majority of cases
*Erionite-fibre exposure: naturally occurring mineral used in building, particularly in Turkey
*Erionite-[[Fiber|fibre]] [[Exposure (photography)|exposure]]
*Simian virus 40 (SV40)
*[[SV40|Simian virus 40 (SV40)]]
*Radiation exposure
*[[radiation|Radiation exposure]]
*[[Genetics|Genetic]] predisposition


===Asbestos===
===Asbestos===
The strongest and most common cause for mesothelioma is occupational exposure to [[asbestos]], which has been widely used in building materials and many industries.<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref> Asbestos is the name of a group of minerals that occur naturally and can be separated into long, thin fibres. Asbestos fibres are very fine. When they are inhaled, they can make their way to the smallest airways of the lung and the [[mesothelium]]. The fibres get into the lung and settle in the [[pleura]] where they can eventually cause pleural mesothelioma. If they are coughed up and then swallowed, asbestos fibres can also settle in the [[peritoneum]]. This is probably the cause of peritoneal mesothelioma. The link between asbestos and mesothelioma has been well known for many years. According to the International Agency for Research on Cancer (IARC) and the US National Toxicology Program, all forms of asbestos are known to cause cancer. Most people with mesothelioma have a history of asbestos exposure. Mesothelioma has a long latency period, which means it usually doesn’t develop for 15–40, or more, years after exposure to asbestos. There are 2 types of exposure to asbestos:
* The strongest and most common cause for mesothelioma is occupational exposure to [[asbestos]], which has been widely used in building materials and many industries.<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>  
 
* Asbestos is naturally occurring group of mineral consisting of very fine,long and thin fibers.  
''Direct exposure'' affects people who come into contact with asbestos directly. This may include:<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>
* Being so fine, they can be inhaled easily and may be lodged in the smallest airways of the lung and the [[mesothelium]], eventually leading to pleural mesothelioma.  
*workers in asbestos mines or mills
* Sometimes, instead of inhalation, the fibers are coughed up and swallowed. This way they can settle in the peritoneum to cause peritoneal mesothelioma.  
*producers of asbestos products or asbestos-based products
* According to the International Agency for Research on Cancer (IARC) and the US National Toxicology Program, all forms of asbestos are known to cause cancer. Most people with mesothelioma have a history of asbestos exposure.
*construction workers, carpenters and painters
* Mesothelioma has a long latency period, which means it usually doesn’t develop for 15–40, or more, years after exposure to asbestos.  
*shipyard workers
* There are 2 types of '''exposure''' to asbestos:
*manufacturers of cement
** '''''Direct exposure''''' affects people who come into contact with asbestos directly. This may include:<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref> <ref name="pmid10642417">{{cite journal| author=Gennaro V, Finkelstein MM, Ceppi M, Fontana V, Montanaro F, Perrotta A et al.| title=Mesothelioma and lung tumors attributable to asbestos among petroleum workers. | journal=Am J Ind Med | year= 2000 | volume= 37 | issue= 3 | pages= 275-82 | pmid=10642417 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10642417  }}</ref>
*insulation workers
*** Asbestos mines/mills workers
*electricians and heating tradespeople
*** Asbestos products/asbestos-based products producers
*plumbers
*** Construction workers, carpenters and painters
*demolition workers
*** Shipyard workers
*automotive industry workers, including brake and clutch repair workers
*** Cement manufacturers
*people who live near an asbestos factory or mine
*** Insulation workers
*people who worked in buildings where asbestos was present and was disturbed
*** Electricians and heating tradespeople
*** Plumbers
*** Demolition workers
*** Automotive industry workers, including brake and clutch repair workers        
** '''''Indirect exposure''''' affects people who come in contact with asbestos in other ways. This may include:<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>
*** Family members who are exposed to asbestos from fibres brought home on a worker’s clothing
*** People who live in or near an asbestos factory or mine


''Indirect exposure'' affects people who come in contact with asbestos in other ways. This may include:<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>
* The risk of developing mesothelioma is related to how much asbestos a person was exposed to and how long the exposure lasted.  
*family members who are exposed to asbestos from fibres brought home on a worker’s clothing
* People exposed at an early age, for a long period of time and to greater amounts of asbestos are more likely to develop mesothelioma.  
*people living close to a mine who may be exposed to asbestos in dust
* Occasionally, mesothelioma develops in people who have never been exposed to asbestos.<ref name="pmid15841689">{{cite journal| author=Henderson DW, Rödelsperger K, Woitowitz HJ, Leigh J| title=After Helsinki: a multidisciplinary review of the relationship between asbestos exposure and lung cancer, with emphasis on studies published during 1997-2004. | journal=Pathology | year= 2004 | volume= 36 | issue= 6 | pages= 517-50 | pmid=15841689 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15841689  }}</ref>
 
The risk of exposure to asbestos is highest for people who mine and export asbestos or those who work with it in manufacturing. The risk of developing mesothelioma is related to how much asbestos a person was exposed to and how long the exposure lasted. People exposed at an early age, for a long period of time and to greater amounts of asbestos are more likely to develop mesothelioma. Occasionally, mesothelioma develops in people who have never been exposed to asbestos.<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>


===Erionite===
===Erionite===
Erionite is a known human carcinogen that is linked to the development of pleural and peritoneal mesothelioma. It is a naturally-occurring mineral that belongs to a group of minerals called zeolites.<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref> Zeolites are chemically related to asbestos and erionite has asbestos-like fibres. Erionite is common in the soil in parts of Turkey and materials made with erionite are used in construction in these regions. High rates of mesothelioma in these areas are due to exposure to this mineral.<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>
* Erionite is another naturally occurring mineral, happens to be a known human carcinogen associated with development of pleural and peritoneal mesothelioma.  
* The group of minerals, erionite belongs to is called zeolites.<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>  
* Zeolites are chemically related to asbestos and erionite has asbestos-like fibres.  
* Erionite is common in the soil in parts of Turkey and materials made with erionite are used in construction in these regions.  
* High rates of mesothelioma in these areas are due to exposure to this mineral.<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>


===Ionizing Radiation===
===Ionizing Radiation===
People who have been treated with radiation therapy to the chest or abdomen for lymphoma, breast cancer, lung cancer, or other cancers can cause mesothelioma.<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref> Although the risk of mesothelioma is higher in people who have been treated with radiation therapy, mesothelioma is likely to occur in only a very small number of these people. There have been reports linking mesothelioma to Thorotrast (thorium dioxide). [[Thorotrast]] is a contrast medium once used for imaging tests, but it is no longer used.<ref name=Riskfactorsformesothelioma1>Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>
* People who have been treated with radiation therapy to the chest or abdomen for lymphoma, breast cancer, lung cancer, or other cancers can cause mesothelioma.<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>  
* Although the risk of mesothelioma is higher in people who have been treated with radiation therapy, mesothelioma is likely to occur in only a very small number of these people.  
* There have been reports linking mesothelioma to Thorotrast (thorium dioxide). [[Thorotrast]] is a contrast medium once used for imaging tests, but it is no longer used.<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>


===Simian virus 40===
===Simian virus 40===
Infection with [[SV40]] might increase the risk of developing mesothelioma. Between 1955 and 1963, some polio vaccines were contaminated with SV40, which may have contributed to some cases of mesothelioma. It is thought that SV40 may act as a co-factor with asbestos in causing mesothelioma.
* Infection with [[SV40]] may cause mesothelioma.
* Evidence suggested the contamination of polio vaccines with SV40 from 1955 to 1963, which may have contributed to some cases of mesothelioma.
* It is thought that SV40 may act as a co-factor with asbestos in causing mesothelioma.<ref name="Riskfactorsformesothelioma1">Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016</ref>
 
=== Genetic predesposition ===
* Based on the fact that malignant mesothelioma clustering was observed in few families, a study was conducted in 2012 on caucasian american population to determine the genetic association.
 
* It was found that people with a somatic germline mutation in their BAP1 gene is associated with higher risk of developing mesothelioma and uveal melanoma.<ref name="pmid21874000" />


==References==
==References==
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatima Shaukat, MD [2]Parminder Dhingra, M.D. [3]

Overview

Common causes of mesothelioma include asbestos-fibre exposure, erionite-fibre exposure, Simian virus 40, radiation exposure and genetic predesposition[1][2]

Causes

Mesothelioma is caused by:[1][2]

Asbestos

  • The strongest and most common cause for mesothelioma is occupational exposure to asbestos, which has been widely used in building materials and many industries.[1]
  • Asbestos is naturally occurring group of mineral consisting of very fine,long and thin fibers.
  • Being so fine, they can be inhaled easily and may be lodged in the smallest airways of the lung and the mesothelium, eventually leading to pleural mesothelioma.
  • Sometimes, instead of inhalation, the fibers are coughed up and swallowed. This way they can settle in the peritoneum to cause peritoneal mesothelioma.
  • According to the International Agency for Research on Cancer (IARC) and the US National Toxicology Program, all forms of asbestos are known to cause cancer. Most people with mesothelioma have a history of asbestos exposure.
  • Mesothelioma has a long latency period, which means it usually doesn’t develop for 15–40, or more, years after exposure to asbestos.
  • There are 2 types of exposure to asbestos:
    • Direct exposure affects people who come into contact with asbestos directly. This may include:[1] [3]
      • Asbestos mines/mills workers
      • Asbestos products/asbestos-based products producers
      • Construction workers, carpenters and painters
      • Shipyard workers
      • Cement manufacturers
      • Insulation workers
      • Electricians and heating tradespeople
      • Plumbers
      • Demolition workers
      • Automotive industry workers, including brake and clutch repair workers
    • Indirect exposure affects people who come in contact with asbestos in other ways. This may include:[1]
      • Family members who are exposed to asbestos from fibres brought home on a worker’s clothing
      • People who live in or near an asbestos factory or mine
  • The risk of developing mesothelioma is related to how much asbestos a person was exposed to and how long the exposure lasted.
  • People exposed at an early age, for a long period of time and to greater amounts of asbestos are more likely to develop mesothelioma.
  • Occasionally, mesothelioma develops in people who have never been exposed to asbestos.[4]

Erionite

  • Erionite is another naturally occurring mineral, happens to be a known human carcinogen associated with development of pleural and peritoneal mesothelioma.
  • The group of minerals, erionite belongs to is called zeolites.[1]
  • Zeolites are chemically related to asbestos and erionite has asbestos-like fibres.
  • Erionite is common in the soil in parts of Turkey and materials made with erionite are used in construction in these regions.
  • High rates of mesothelioma in these areas are due to exposure to this mineral.[1]

Ionizing Radiation

  • People who have been treated with radiation therapy to the chest or abdomen for lymphoma, breast cancer, lung cancer, or other cancers can cause mesothelioma.[1]
  • Although the risk of mesothelioma is higher in people who have been treated with radiation therapy, mesothelioma is likely to occur in only a very small number of these people.
  • There have been reports linking mesothelioma to Thorotrast (thorium dioxide). Thorotrast is a contrast medium once used for imaging tests, but it is no longer used.[1]

Simian virus 40

  • Infection with SV40 may cause mesothelioma.
  • Evidence suggested the contamination of polio vaccines with SV40 from 1955 to 1963, which may have contributed to some cases of mesothelioma.
  • It is thought that SV40 may act as a co-factor with asbestos in causing mesothelioma.[1]

Genetic predesposition

  • Based on the fact that malignant mesothelioma clustering was observed in few families, a study was conducted in 2012 on caucasian american population to determine the genetic association.
  • It was found that people with a somatic germline mutation in their BAP1 gene is associated with higher risk of developing mesothelioma and uveal melanoma.[2]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Risk factors for mesothelioma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/risks/?region=on. Accessed on February 8, 2016
  2. 2.0 2.1 2.2 Testa JR, Cheung M, Pei J, Below JE, Tan Y, Sementino E; et al. (2011). "Germline BAP1 mutations predispose to malignant mesothelioma". Nat Genet. 43 (10): 1022–5. doi:10.1038/ng.912. PMC 3184199. PMID 21874000.
  3. Gennaro V, Finkelstein MM, Ceppi M, Fontana V, Montanaro F, Perrotta A; et al. (2000). "Mesothelioma and lung tumors attributable to asbestos among petroleum workers". Am J Ind Med. 37 (3): 275–82. PMID 10642417.
  4. Henderson DW, Rödelsperger K, Woitowitz HJ, Leigh J (2004). "After Helsinki: a multidisciplinary review of the relationship between asbestos exposure and lung cancer, with emphasis on studies published during 1997-2004". Pathology. 36 (6): 517–50. PMID 15841689.


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