Esophageal cancer (EC), which includes squamous cell carcinoma (ESCC) and adenocarcinoma (EAC), is an important cancer with poor prognosis and high mortality rate. Several occupational exposures have been associated with EC. We aim to investigate the association between occupational asbestos exposure and EC risk, considering types of asbestos and histology of the disease. We included studies mentioned in the list of references in previous reviews and pooled analyses, and we conducted an independent search in PubMed and Scopus. Forest plots of relative risks (RR) were constructed based on the association between occupational asbestos and EC risk. Random-effects models were used to address heterogeneity between 48 independent cohort and case-control studies. We found an association between occupational asbestos exposure and EC (meta-relative risk [RR] = 1.20, 95% confidence interval [CI] = 1.09-1.32; I2 = 58.8%, p-heterogeneity [het] <.001). The results of stratification by job (p-het = .20) indicate an increased RR among asbestos product workers (RR = 1.39, 95% CI = 1.07-1.81), asbestos applicators (RR = 1.41, 95% CI = 1.20-1.67), and construction workers (RR = 1.12, 95% CI = 1.02-1.24). There was no heterogeneity in meta-RR according to outcome (p = .29), geographic region (p = .69), year of publication (p = .59), quality score (p = .73), asbestos type (p = .93), study design (p = .87), and gender (p = .88), control for potential confounders (p = .20), year of first employment (p = .94) and exposure level (p = .43). The stratification analysis by histology type found an increased RR for both ESCC 1.33(1.03-1.71) and EAC 1.45(1.03-2.04) (p-het = .68). We didn't find evidence of publication bias (p = .07). The results of our study suggest that occupational asbestos exposure is associated with an increased risk of EC in both histology types.

中文翻译：

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职业石棉暴露与食管癌风险：系统评价和荟萃分析

食管癌（EC）包括鳞状细胞癌（ESCC）和腺癌（EAC），是一种预后差、死亡率高的重要癌症。一些职业暴露与 EC 有关。我们的目的是考虑石棉类型和疾病的组织学，调查职业石棉暴露与 EC 风险之间的关联。我们纳入了之前综述和汇总分析中参考文献列表中提到的研究，并在 PubMed 和 Scopus 中进行了独立检索。相对风险 (RR) 森林图是根据职业石棉与 EC 风险之间的关联构建的。使用随机效应模型来解决 48 项独立队列研究和病例对照研究之间的异质性。我们发现职业石棉暴露与 EC 之间存在关联（元相对风险 [RR] = 1.20，95% 置信区间 [CI] = 1.09-1.32；I2 = 58.8%，p异质性 [het] <.001）。按工作分层的结果 ( p -het = .20) 表明石棉产品工人 (RR = 1.39, 95% CI = 1.07-1.81) 和石棉涂抹工 (RR = 1.41, 95% CI = 1.20-1.67) 的 RR 增加）和建筑工人（RR = 1.12，95% CI = 1.02-1.24）。根据结果​​ ( p  = .29)、地理区域 ( p  = .69)、发表年份 ( p  = .59)、质量评分 ( p  = .73)、石棉类型 ( p  = .93)、研究设计 ( p  = .87) 和性别 ( p  = .88)、潜在混杂因素控制 ( p  = .20)、首次就业年份 ( p  = .94) 和暴露水平 ( p  = .94) .43）。按组织学类型进行的分层分析发现，ESCC 1.33(1.03-1.71) 和 EAC 1.45(1.03-2.04) 的 RR 均增加 ( p -het = .68)。我们没有发现发表偏倚的证据 ( p  = .07)。我们的研究结果表明，职业石棉暴露与两种组织学类型的 EC 风险增加相关。