PT  - JOURNAL ARTICLE
AU  - C. Paris
AU  - J. Benichou
AU  - S. Bota
AU  - S. Sagnier
AU  - J. Metayer
AU  - S. Eloy
AU  - J-B. Auliac
AU  - G. Nouvet
AU  - L. Thiberville
TI  - Occupational and nonoccupational factors associated with high grade bronchial pre-invasive lesions
AID  - 10.1183/09031936.03.00001503
DP  - 2003 Feb 01
TA  - European Respiratory Journal
PG  - 332--341
VI  - 21
IP  - 2
4099  - http://erj.ersjournals.com/content/21/2/332.short
4100  - http://erj.ersjournals.com/content/21/2/332.full
SO  - Eur Respir J2003 Feb 01; 21
AB  - Besides tobacco exposure, factors associated with the development of pre-invasive bronchial lesions are not known. Autofluorescence bronchoscopy was used to assess the prevalence of severe dysplasia and carcinoma in situ (SD/CIS) of the proximal bronchial tree in relation to occupational or nonoccupational carcinogen exposure. Among the 241 individuals in this study, the overall prevalence of at least one SD/CIS was 9% (21 subjects). Multivariable analysis revealed significant and independent associations between presence of SD/CIS and: 1) active smoking, relative to former smokers; 2) presence of synchronous invasive lung cancer; 3) duration of asbestos exposure and; 4) exposure to other occupational carcinogens. The independent associations of synchronous lung cancer with severe dysplasia and carcinoma, after adjusting for both occupational and nonoccupational carcinogen exposures, suggest other mechanisms than a field cancerisation may be involved in the carcinogenesis of these pre-invasive lesions. Moreover, active smokers, patients with recently resected invasive lung cancer and workers occupationally exposed to bronchial carcinogens may represent a population of choice for early cancer endoscopic detection programmes in view of their high severe dysplasia and carcinoma prevalence. This research was supported by a “Programme Hospitalier de Recherche Clinique” grant from the French Ministry of Research (1996).